Korean Journal of Thoracic and Cardiovascular Surgery 2018; 51(5): 333-337  
Pinch-Off Syndrome, a Rare Complication of Totally Implantable Venous Access Device Implantation: A Case Series and Literature Review
Burak Mehmet Ilhan, M.D.1, İsmail Cem Sormaz, M.D.1, Rüştü Türkay, M.D.2
1Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, 
2Department of Radiology, Bakırköy Education and Research Hospital
Corresponding author: Burak Mehmet Ilhan, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet Caddesi, 34093 Fatih, Istanbul, Turkey
(Tel) 90-212-414-2000 (Fax) 90-212-414-2222 (E-mail) burakmd@yahoo.com
Received: February 8, 2018; Revised: July 31, 2018; Accepted: August 2, 2018.; Published online: October 5, 2018.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properlycited.
Abstract
Background: Pinch-off syndrome (POS) is a rare complication after totally implantable venous access device (TIVAD) implantation. In cancer patients, it is important to prevent this rare complication and to recognize it early if it does occur. We present a case series of POS after TIVAD implantation and the results of a literature search about this complication. Methods: From July 2006 to December 2015, 924 permanent implantable central venous catheter implantation procedures were performed. The most common indication was vascular access for chemotherapy. Results: POS occurred in 5 patients in our clinic. Two patients experienced POS within 2 weeks, and the other 3 patients were admitted to department of surgery, Istanbul Faculty of Medicine at 6 to 14 months following implantation. The catheters were found to be occluded during medication administration, and all patients complained of serious pain. The transected fragments of the catheters had migrated to the heart. They were successfully removed under angiography with a single-loop snare. Conclusion: POS is a serious complication after TIVAD implantation. It is important to be aware of this possibility and to make an early diagnosis in order to prevent complications such as drug extravasation and occlusion events
Keywords: Totally implantable venous access device; Pinch off syndrome; Catheter fracture


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