causes of fracture at catheter of totally implantable venous access port: a systematic review

A totally implantable venous access port (tivap) plays a crucial role in the treatment of patients in oncology. catheter fracture is a serious complication with an estimated incidence of 0, 1% - 1%. the objective of this systematic review is to analyze the mechanism of tivap fracture to make physicians aware of this fatal entity. a search of the literature between 1980 and 2019 was conducted using pubmed, ovid, medline, and cochrane systematic review databases. the search identified 18 case reports and 8 retrospective studies. fracture of the middle part of the catheter may be induced by constant compression of the catheter between the first-rib and clavicle, which is called the pinch-off syndrome. catheter fracture at the port-catheter junction may be caused by extrinsic compression near the port-catheter junction combined with material fatigue due to repeated bending of the catheter with shoulder movement. there is no specific cause for the fracture of a catheter tip. an annual chest x-ray is recommended for the early detection of tivap catheter fracture. percutaneous endovascular retrieval of a dislodged port-a catheter is both safe and effective.