In situ breakage of a totally implanted venous access system

Totally implantable systems for venous access are now in wide clinical use. They have been shown to have several advantages when compared with earlier systems. However, the advantages of total implantation also contain risks for new complications. In situ breakages may have disastrous results when unnoticed. In situ separations have been reported with systems consisting of a separate reservoir and catheter. A case is reported where in situ breakage occurred in a system with prefixed catheter. The catheter migrated into pulmonary artery and was removed with Odman catheter and foreign body extractor. The precise cause for the separation could not be ascertained. It is emphasized that during insertion the silicone catheter should not be handled with surgical instruments and that the continuity of the system should be checked prior to use.