# Spontaneous Catheter Fracture Leading to a Retained Fragment After Central Venous Access Port Removal: Should Preoperative Chest X-rays Be Obtained?

## TL;DR

This paper discusses a rare case of a broken central venous access port during removal and suggests using chest X-rays before removal to prevent complications.

## Contribution

The paper introduces a recommendation for preoperative chest X-rays to detect potential catheter fractures before port removal.

## Key findings

- Spontaneous catheter fracture during port removal is rare but can lead to retained fragments.
- A preoperative chest X-ray can help identify catheter fractures before removal.
- Adhesive fibrous sheaths may complicate port removal after long-term use.

## Abstract

Central venous access ports are used to administer chemotherapy, antibiotics, and total parenteral nutrition, and for frequent blood draws. The device consists of a subcutaneous reservoir (port) and an intravascular piece (catheter). Access is achieved via direct venipuncture of the subclavian, internal jugular, or cephalic vein with the tip at the cavoatrial junction.

Retained central venous access ports are relatively uncommon. In most cases, an indwelling time greater than two years can cause an adhesive fibrous sheath to form around the catheter, contributing to more difficult removal. Spontaneous fracture of ports is even less common. Our goal is to discuss spontaneous catheter fracture of a central venous access port leading to a retained fragment in an adult. In this paper, we suggest obtaining a preoperative chest X-ray (CXR) in certain patients prior to central venous access port removal and explain the reasoning behind doing so.