Pinch-off syndrome: Case report and collective review of the literature

Pinch-off syndrome: Case report and collective review of the literature

Mirza B; Vanek V W; Kupensky D T

American Surgeon

2004

2004-07

Pinch-off syndrome (POS) occurs when a long-term central venous catheter is compressed between the clavicle and the first rib. The compression can cause transient obstruction of the catheter and may result in a tear or even complete transsection and embolization of the catheter. POS may be preceded by a finding of "pinch-off sign" on chest X-ray (CXR) films in which the catheter is indented as it passes beneath the clavicle. We performed a collective review of the 109 cases of POS in the medical literature and report 3 new cases. On average, POS occurs 5.3 months after the insertion of the catheter but has ranged from immediately after insertion to 60 months later. If the subclavian vein is used for access, then an upright CXR should be obtained after the procedure and periodically thereafter to rule-out POS. Treatment of POS is removal of the catheter. If the tip of the catheter has embolized, it can usually be retrieved percutaneously with a transvenous snare. POS can be prevented by using the internal jugular vein for access rather than the subclavian vein.

Surgery; electron-microscopy; system; hemodialysis; embolization; permanent subclavian catheters; port; rare complication; scanning; sign; spontaneous fracture; venous access devices

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Journal Article or Conference Abstract Publication

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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

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