Wandering Catheter Through Pulmonary Vasculature

Embolization of central catheter fragments is a rare but well-documented complication of indwelling vascular devices. We describe a unique case of a catheter fragment migrating through the pulmonary vasculature after indwelling reservoir catheter removal in a 42 year-old female with metastatic breast cancer. The catheter fragment was initially visualized in the right upper lobe pulmonary artery two years after removal. One year later, it was seen in the right middle lobe PA. Two years later, it had migrated to the right lower lobe PA, where it remained for at least three months before the patient was lost to follow-up. The patient remained clinically asymptomatic from the catheter fragment throughout this time. Although there have been numerous case reports published regarding catheter embolization, to our knowledge, migration within the pulmonary vasculature has not been described. This is an interesting illustration of the hemodynamics of pulmonary blood flow and transient retrograde flow in the lungs.