Chen J, Tang M, Han QY, Tang L, Yu TH, Zhao YP, He CW. Difficulty removing a totally implantable venous access port: A case report. World J Clin Cases 2025; 13(13): 102457 [PMID: 40330284 DOI: 10.12998/wjcc.v13.i13.102457]
Corresponding Author of This Article
Chong-Wu He, PhD, Department of Breast Surgery, Jiangxi Cancer Hospital, No. 519 East Beijing Road, Nanchang 330029, Jiangxi Province, China. 361439920088@email.ncu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Difficulty removing a totally implantable venous access port: A case report
Jing Chen, Mu Tang, Qin-Yuan Han, Lei Tang, Teng-Hua Yu, Yan-Ping Zhao, Chong-Wu He
Jing Chen, Department of Nursing, Nanchang Medical College, Nanchang 330052, Jiangxi Province, China
Mu Tang, Teng-Hua Yu, Chong-Wu He, Department of Breast Surgery, Jiangxi Cancer Hospital, Nanchang 330029, Jiangxi Province, China
Qin-Yuan Han, Lei Tang, Graduate School, Nanchang University, Nanchang 330006, Jiangxi Province, China
Yan-Ping Zhao, Department of Vascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Co-corresponding authors: Yan-Ping Zhao and Chong-Wu He.
Author contributions: Chen J, He CW, Han QY, and Tang L contributed to manuscript writing and editing; Tang M, Yu TH, and Zhao YP contributed to digital subtraction angiography imaging analysis; He CW, Chen J, Zhao YP contributed to manuscript revision; Chen J, He CW, and Yu TH contributed to fund acquired; Zhao YP, He CW contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Supported by the Science and Technology Research Project of Jiangxi Provincial Education Department, No. GJJ2208202; Science and Technology Program Project of Health Commission of Jiangxi Province, No. 202510069; Jiangxi Cancer Hospital Doctoral Start-up Fund, No. BSQDJ202309; and Jiangxi Province Gan Po Talent Support Program, No. 20232BCJ23035.
Informed consent statement: Written informed consent was obtained from the patient and submitted.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Chong-Wu He, PhD, Department of Breast Surgery, Jiangxi Cancer Hospital, No. 519 East Beijing Road, Nanchang 330029, Jiangxi Province, China. 361439920088@email.ncu.edu.cn
Received: October 21, 2024 Revised: December 5, 2024 Accepted: December 27, 2024 Published online: May 6, 2025 Processing time: 85 Days and 10.4 Hours
Abstract
BACKGROUND
This case report examines the challenges associated with removing a totally implantable venous access port (TIVAP) used for long-term chemotherapy in a patient with breast cancer. Prolonged use of TIVAPs can result in complications such as catheter kinking, thrombosis, and adhesions between the catheter and surrounding tissues, potentially complicating their removal.
CASE SUMMARY
A breast cancer patient with bone metastasis presented with difficulty aspirating blood from a TIVAP that had been placed in the right internal jugular vein for 3 years. Initial removal attempts at the Department of Venous Access Center were unsuccessful, likely due to adhesions, necessitating a subsequent successful catheter extraction in a hybrid operating room. Imaging revealed no abnormalities, and the catheter was removed using a mosquito clamp to detach it from surrounding tissues.
CONCLUSION
This case highlights the challenges of removing TIVAPs inserted via the internal jugular vein, particularly when the catheter traverses the sternocleidomastoid muscle. Repeated neck movements might lead to significant adhesions around the catheter, complicating its removal. Careful consideration should be given during catheter placement to avoid muscle-related adhesions and facilitate smoother extraction in long-term use.
Core Tip: Totally implantable venous access ports (TIVAPs) are an effective catheterization method for patients with cancer, offering safe, convenient, and cosmetically long-term vascular access. This case highlights the complications that could arise from prolonged TIVAP use. For patients with TIVAPs inserted via the internal jugular vein, careful consideration of catheter placement is essential. Avoiding passage through active muscles, such as the sternocleidomastoid, might reduce the risk of adhesions and facilitate easier catheter removal.
