Catheter fragment removal from a persistent left superior vena cava in a pediatric patient

Area of Science:

• Pediatric Surgery
• Vascular Access Devices
• Medical Device Complications

Background:

• Tunneled central venous catheters and ports are crucial for long-term pediatric nutrition, hydration, and medication delivery.
• Complete removal of these devices is standard practice once they are no longer needed.
• Potential complications include infections, thrombosis, occlusion, and device fracture with fragment migration.

Observation:

• A case of catheter fragmentation is presented in a pediatric patient.
• The fragmentation occurred during the removal of a 3-year-old left chest port.
• The port was originally placed into the left superior vena cava (SVC).

Findings:

• Catheter fragmentation represents a rare but significant complication during the removal of venous access devices.
• This event underscores the risks associated with long-term indwelling devices.
• Fragment migration is a potential sequela, posing further clinical challenges.

Implications:

• Awareness of catheter fragmentation is crucial for pediatric surgeons and interventional radiologists.
• Careful technique during device removal may mitigate risks.
• Further investigation into prevention and management strategies for device fragmentation is warranted.