Pinch-off syndrome
A 48-year-old man with rectosigmoid colon cancer had undergone low anterior resection on July 15, 2011. For adjuvant chemotherapy, an implantable venous port was inserted through the right subclavian vein, and its location was confirmed by chest radiography (). No associated complication with the location of the catheter, and no pinch-off sign was suspected. The patient had undergone adjuvant chemotherapy 4 times without any unusual problems, ended the therapy of his own accord, and was lost to follow-up. Six months after he terminated the therapy, the patient returned to the outpatient clinic. His test results indicated that his disease had aggravated; therefore, chemotherapy was initiated again with different medications. He had chemotherapy twice during 2 months without any unusual complications but the port became dysfunctional after he was hospitalized for the third cycle; therefore, the removal of the original venous catheter and reinsertion through the left subclavian route were conducted. In the chest radiograph taken immediately after the second cannulation, some parts of the catheter of the removed right subclavian venous port remained (). In a retrospective review of the patient's chest radiographs, we observed catheter's luminal narrowing, that was not present on the initial chest X-ray, in the chest radiograph that was taken 4 months after the insertion of the right subclavian venous port (). It is assumed that the weakened catheter was fractured by the force used during the removal. To find out the exact location of the catheter, pulmonary arteriography was performed (). The patient was referred to an interventional radiologist, and the embolized catheter was successfully removed by the percutaneous approach through the right common femoral artery ().