SPONTANEOUS MIGRATION OF SUBCUTANEOUS CENTRAL VENOUS CATHETERS

Along with the increasing use of central venous catheters have come an increasing number of complications. Although many are discovered at t he time of insertion, others can occur at a later time. If unrecognize d, problems may ensue. We describe two cases of spontaneous migration of subcutaneous venous access catheters to illustrate the importance o f early recognition and treatment. In one case, the patient was asympt omatic at the time the migration was discovered, and the catheter was removed. However, in the second case, the patient required hospitaliza tion for sepsis following clot formation around a catheter whose tip w as in the internal jugular vein. Migration of a central venous cathete r can lead to a number of cardiovascular, neurologic, and infectious c omplications. Although a number of methods of nonoperative interventio n have been used to correct the position of central venous catheters, it is difficult to fix a subcutaneous port, because the entire device is implanted under the skin. Removal and replacement are usually requi red, especially if the catheter is not in the ideal location after ini tial placement.