Port-a-Cath Fragmentation Causing Recurrent Chest Pressure and Dizziness in an Elderly Man: A Case Report

Authors

DOI:

https://doi.org/10.5195/ijms.2023.3234

Keywords:

Dizziness, Hypertension, Pulmonary artery, Radiology Interventional, Case Report, Port-a-catheter, Fluoroscopic retrieval, Follicular lymphoma, Pulmonary artery embolization, Pulmonary hypertension symptoms

Abstract

Background: A port-a-catheter is a long-term vascular access device designed for patients requiring prolonged access to a large venous vessel. These devices are typically surgically inserted into the internal jugular vein, subclavian vein, or superior vena cava.

 

Case: A 71-year-old male with a history of follicular lymphoma in remission following treatment with six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) presented with a 10-week history of intermittent chest pressure and dizziness. During a routine follow-up visit with his oncologist, a screening computed tomography (CT) scan revealed a fragmented port-a-catheter. The catheter fragment was coiled within the right and left main pulmonary arteries. The patient underwent fluoroscopic-guided retrieval of the fragment, resulting in complete resolution of his symptoms.

 

Conclusion: Fractured port-a-catheters can migrate to the pulmonary arteries, leading to increased pulmonary pressure and irritation of the pulmonary endothelium. This can manifest as chest discomfort, chest pressure, dizziness, and episodic hypertensive emergencies. Prompt recognition, confirmation with imaging, and retrieval of the fractured catheter are crucial to prevent serious complications. Physicians should consider catheter fragmentation and migration as possible causes when diagnosing patients with similar symptoms who have a known indwelling port.

References

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6. Li Y, Chen J, Li Z, Lu H, Ren K, Ren J, et al. Successful percutaneous transvenous retrieval of intravascular fractured port catheter: a single center experience. J Cardiothorac Surg. 2020 May 18;15(1).

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Published

2025-12-05

How to Cite

Tepfenhart, T., Fort, C., Twahirwa, M., & Jensen, B. (2025). Port-a-Cath Fragmentation Causing Recurrent Chest Pressure and Dizziness in an Elderly Man: A Case Report. International Journal of Medical Students. https://doi.org/10.5195/ijms.2023.3234

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Forthcoming

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Case Report

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Copyright (c) 2025 Tyler Tepfenhart, Callie Fort, Marcel Twahirwa, Bryce Jensen

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