Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2025; 13(13): 102457
Published online May 6, 2025. doi: 10.12998/wjcc.v13.i13.102457
Difficulty removing a totally implantable venous access port: A case report
Jing Chen, Mu Tang, Qin-Yuan Han, Lei Tang, Teng-Hua Yu, Yan-Ping Zhao, Chong-Wu He
Jing Chen, Department of Nursing, Nanchang Medical College, Nanchang 330052, Jiangxi Province, China
Mu Tang, Teng-Hua Yu, Chong-Wu He, Department of Breast Surgery, Jiangxi Cancer Hospital, Nanchang 330029, Jiangxi Province, China
Qin-Yuan Han, Lei Tang, Graduate School, Nanchang University, Nanchang 330006, Jiangxi Province, China
Yan-Ping Zhao, Department of Vascular Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Co-corresponding authors: Yan-Ping Zhao and Chong-Wu He.
Author contributions: Chen J, He CW, Han QY, and Tang L contributed to manuscript writing and editing; Tang M, Yu TH, and Zhao YP contributed to digital subtraction angiography imaging analysis; He CW, Chen J, Zhao YP contributed to manuscript revision; Chen J, He CW, and Yu TH contributed to fund acquired; Zhao YP, He CW contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Supported by the Science and Technology Research Project of Jiangxi Provincial Education Department, No. GJJ2208202; Science and Technology Program Project of Health Commission of Jiangxi Province, No. 202510069; Jiangxi Cancer Hospital Doctoral Start-up Fund, No. BSQDJ202309; and Jiangxi Province Gan Po Talent Support Program, No. 20232BCJ23035.
Informed consent statement: Written informed consent was obtained from the patient and submitted.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chong-Wu He, PhD, Department of Breast Surgery, Jiangxi Cancer Hospital, No. 519 East Beijing Road, Nanchang 330029, Jiangxi Province, China. 361439920088@email.ncu.edu.cn
Received: October 21, 2024
Revised: December 5, 2024
Accepted: December 27, 2024
Published online: May 6, 2025
Processing time: 85 Days and 10.4 Hours
Abstract
BACKGROUND

This case report examines the challenges associated with removing a totally implantable venous access port (TIVAP) used for long-term chemotherapy in a patient with breast cancer. Prolonged use of TIVAPs can result in complications such as catheter kinking, thrombosis, and adhesions between the catheter and surrounding tissues, potentially complicating their removal.

CASE SUMMARY

A breast cancer patient with bone metastasis presented with difficulty aspirating blood from a TIVAP that had been placed in the right internal jugular vein for 3 years. Initial removal attempts at the Department of Venous Access Center were unsuccessful, likely due to adhesions, necessitating a subsequent successful catheter extraction in a hybrid operating room. Imaging revealed no abnormalities, and the catheter was removed using a mosquito clamp to detach it from surrounding tissues.

CONCLUSION

This case highlights the challenges of removing TIVAPs inserted via the internal jugular vein, particularly when the catheter traverses the sternocleidomastoid muscle. Repeated neck movements might lead to significant adhesions around the catheter, complicating its removal. Careful consideration should be given during catheter placement to avoid muscle-related adhesions and facilitate smoother extraction in long-term use.

Keywords: Internal jugular vein; Remove; Totally implantable venous access port; Catheter; Case report

Core Tip: Totally implantable venous access ports (TIVAPs) are an effective catheterization method for patients with cancer, offering safe, convenient, and cosmetically long-term vascular access. This case highlights the complications that could arise from prolonged TIVAP use. For patients with TIVAPs inserted via the internal jugular vein, careful consideration of catheter placement is essential. Avoiding passage through active muscles, such as the sternocleidomastoid, might reduce the risk of adhesions and facilitate easier catheter removal.