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Reminder of important clinical lesson
Central venous catheter embolisation
  1. Elizabeth Harrison1,
  2. Simon Lal1,2
  1. 1Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
  2. 2Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
  1. Correspondence to Dr Elizabeth Harrison, elizabeth.harrison-3{at}manchester.ac.uk

Summary

Tunnelled central venous catheters are commonly used for a variety of indications, including home parenteral nutrition, but are rarely associated with fracture and embolisation; the risk of embolisation is reported to be greater with catheters placed via the subclavian vein rather than the internal jugular route. We report the case of a 64-year-old woman with type 3 (chronic and irreversible) intestinal failure who presented with pain and swelling on infusion of parenteral nutrition through her internal jugular catheter. A chest x-ray showed fracture and embolisation of her catheter into the right ventricle. The embolised portion was retrieved and removed via the femoral route, without complication and the catheter replaced. We discuss causes of line embolisation, and highlight the possibility of embolisation occurring with an internal jugular catheter.

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