消化器癌の化学療法中に生じたpinch-off syndromeの3症例

Recently Implanted central venous catheter ports（CV ports）are more commonly used inpatients with cancer when long-term venous access is needed for the administration of chemotherapy,antibiotics and nutritional support. Pinch-off syndrome occurs when chronic compressionforces between the clavicle and the first rib. We report three patients with pinch-off syndrome.Case 1 : Two months after placement, the chest radiograph showed grade 2 pinch-off sign. Case 2 :Two months after placement, the chest CT showed complete transection of the catheter at thelevel of the clavicle. The distal fragment was in the hepatic vein, the inferior vena cava and theright atrium. Case 3 : A palpable mass was noticed below the right clavicle when the port wasaccessed. The chest radiograph showed grade 2 pinch-off sign. Removing the catheter, it wasfractured. The distal fragment was in the superior vena cava. Six months after replacement,complete transection of the catheter was occurred. The distal fragment was in the right ventricle.All this distal fragment of the catheter could be retrieved percutaneously with a transvenous snare.Pinch-off syndrome is the potential for serious complication, we study how to prevent pinch-offsyndrome.