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Vascular and Endovascular Surgery
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Hickman Catheter Perforation of the Superior vena Cava with 5-FU Extravasation into the Anterior Mediastinum A Case Report

Marcus E. Carr, JR

Coagulation Special Studies Laboratory, Division of Hematology/Oncology, Departments of Medicine and Pathology, Medical College of Virginia, and McGuire V.A. Medical Center, Richmond, Virginia

Galen L. Wampler

Coagulation Special Studies Laboratory, Division of Hematology/Oncology, Departments of Medicine and Pathology, Medical College of Virginia, and McGuire V.A. Medical Center, Richmond, Virginia

Hickman catheter perforation of the superior vena cava with erosion of the catheter tip into soft tissues and extravasation of 5-fluorouracil into the anterior mediastinum is reported. Symptoms included progressive hoarseness and inter mittent right chest pain. Chest x-ray revealed migration of the catheter tip out of the vessel and extravasation of fluid. Risk factors for this complication in clude left subclavian vein cannulation, positioning of the catheter tip in the upper portion of the superior vena cava, and impingement of the catheter tip against the vessel wall. Good catheter position should be confirmed and tenting of the lateral wall of the superior vena cava excluded by careful examination of a postinsertional chest x-ray.

Vascular and Endovascular Surgery, Vol. 24, No. 6, 443-447 (1990)
DOI: 10.1177/153857449002400613
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