Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 1990 Nov;177(2):353-6
Date
11/01/1990Pubmed ID
2217768DOI
10.1148/radiology.177.2.2217768Scopus ID
2-s2.0-0025043250 (requires institutional sign-in at Scopus site) 258 CitationsAbstract
Implantable central venous access devices placed via the subclavian vein may become obstructed by thrombosis, impingement against a vein wall, or compression between the clavicle and first rib. The latter has been termed pinch-off syndrome (POS). Eleven patients with POS were studied, including one whose catheter had fractured and one whose catheter had fragmented. They were compared with 22 matched control patients and 100 consecutive routine clinic patients. Each catheter was graded: 0 = normal, 1 = abrupt change in course with no luminal narrowing, 2 = luminal narrowing, and 3 = complete catheter fracture. POS was present in most (eight of 11) cases within 3 weeks after placement. A grade 1 catheter was common (33%) among control subjects, but grades 2 and 3 were uncommon (1%). Catheter fracture or fragmentation was seen in two of five cases with long-term (greater than 3 weeks) pinching (grade 2 catheter). The following conclusions were reached: Grade 2 represents significant catheter compression and the potential for serious complications. Grade 1 is of uncertain clinical significance, due to its high prevalence in control subjects.
Author List
Hinke DH, Zandt-Stastny DA, Goodman LR, Quebbeman EJ, Krzywda EA, Andris DAAuthors
Lawrence Goodman MD Emeritus Professor in the Radiology department at Medical College of WisconsinEdward J. Quebbeman MD Emeritus Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Catheterization, Central VenousCatheters, Indwelling
Constriction, Pathologic
Female
Humans
Iatrogenic Disease
Male
Radiography, Thoracic
Subclavian Vein
Syndrome
