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Case report: the malfunctioning implanted venous access device.

Wolfram Schummer1, Claudia Schummer, Christoph Schelenz

  • 1Clinic for Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller University, Germany.

British Journal of Nursing (Mark Allen Publishing)
|April 3, 2003
PubMed
Summary
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Catheter fracture is a rare but serious complication of totally implanted venous access devices (VADs). Early recognition of symptoms and prompt imaging are crucial to prevent severe patient harm.

Area of Science:

  • Medical Devices
  • Vascular Access
  • Complication Management

Background:

  • Totally implanted venous access devices (VADs) offer an alternative to central lines for patients needing frequent intravenous access.
  • Common VAD complications include thrombosis, infection, extrusion, extravasation, and occlusion.

Observation:

  • Catheter fracture with embolization is a rare but potentially severe complication of VADs.
  • Clinical signs may include chest pain, arm paresthesias, cardiac arrhythmias, and infusion resistance.
  • Two cases highlight that typical symptoms may not prompt consideration of fracture, delaying necessary radiological evaluation.

Findings:

  • In the presented cases, catheter fracture with embolization was not initially suspected despite characteristic symptoms.

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  • Radiological assessment of the VAD was not performed, delaying diagnosis.
  • Both patients fortunately avoided serious harm due to the rare complication by chance.

    • Implications:

    • Healthcare professionals must maintain a high index of suspicion for rare VAD complications like catheter fracture.
    • Immediate cessation of infusion and prompt radiological imaging (chest radiograph or angiography) are advised when VAD malfunction is suspected.
    • Awareness and prompt action are critical to prevent potentially life-threatening consequences of VAD catheter fracture and embolization.