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Christoph Evers [1; 2] and Angelos Gazis [3] and Wendy Thuss-Patiance [4] and Albrecht Kretzschmar [2]
Academic Editor: Leo E. H. Lampmann
1, Department of Radiation Oncology, University of Halle, Halle (Saale), Germany, uni-halle.de
2, Department of Medical Oncology, St. Georg Hospital Leipzig, Leipzig, Germany, sanktgeorg.de
3, Department of Radiology, St. Georg Hospital Leipzig, Leipzig, Germany, sanktgeorg.de
4, Department of Pneumology, Protestant Lung Hospital Berlin, Berlin, Germany, pgd-healthcare.com
Received Aug 22, 2017; Revised Nov 13, 2017; Accepted Dec 3, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Overview
Clinical radiological controls after the insertion of central venous catheters (CVC) are of high importance. The CVC should be positioned in the superior vena cava above the right ventricle. The thrombogenicity there is reduced because of the fast flow [1]. Misplacement of the CVC, outside of large vessels, as described in our first case, occurs in more than 7% of procedures and may be associated with life-threatening events [2]. Congenital abnormalities, as mentioned in our second case, are possible as well. Imaging demonstrated a persistent left-sided superior vena cava (PLSSVC). PLSSVC occurs in 0.3–0.5% of the standard population and in 4–12% of individuals with a congenital heart malformation. In 75% of all cases, PLSSVC is an incidental finding [3]. Patients likely to have a PLSSVC are difficult to identify on the basis of a medical history alone.
2. Case Report 1
A central venous catheter was implanted in a 77-year-old patient (56 kg, 168 cm, BMI: 20 kg/m2) suffering from metastatic rectal carcinoma. After insertion, the catheter became infected. 14 days after removal, a new port catheter system (PCS) (powerPort ChronoFlex, Bard, Salt Lake City, USA) was inserted. Under ultrasound-guidance, the catheter was directed into the left brachiocephalic vein. Normal saline solution was injected without any complications. The a.p. chest X-ray showed an atypical position of the catheter tip at...