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ANZSVS Conference 2026
Fishing Expedition in Regional Victoria: An Unusual Case of Thoracic Outlet Syndrome Causing Infusaport Catheter Embolisation
Poster

Poster

Disciplines

Vascular Surgery

Presentation Description

Institution: Grampians Health - Victoria, Australia

Purpose: To report endovascular retrieval of an embolised Infusaport fragment from the left pulmonary artery in a regional Victorian centre, highlighting animated 3D volume rendering for planning, consent, multidisciplinary discussion and venous thoracic outlet syndrome awareness. Methodology: A 49-year-old , muscular male receiving adjuvant chemotherapy after resection of rectosigmoid adenocarcinoma presented with port malfunction. Infusion failed when he turned his head to the right. Chest x-ray showed displaced catheter tubing over the left hemithorax. CTA showed a fractured fragment in the left pulmonary arterial tree, with its proximal end in the left main pulmonary artery, without pulmonary embolus or bleeding. His build and positional dysfunction suggested unrecognised venous thoracic outlet compression, with repetitive costoclavicular impingement likely causing catheter fatigue and fracture. Animated 3D volume rendering defined the anatomy, anticipated arterial pathway, supported consent, and facilitated cardiology and cardiothoracic discussion. Retrieval was performed under fluoroscopic guidance. Results: Under general anaesthesia, ultrasound-guided right common femoral venous access was obtained. The right heart was traversed and the left pulmonary artery selectively catheterised. A 65 cm 12 Fr DrySeal sheath was used as the platform, with a 90 cm 6 Fr Flexor sheath telescoped into the left pulmonary artery. A 6 Fr gooseneck snare captured the catheter tip and the fragment was withdrawn with the sheath construct. The chest port was removed. There was no pulmonary vascular injury, instability or cardiothoracic rescue. He recovered uneventfully and resumed chemotherapy via alternative central access. Conclusion: Pulmonary arterial foreign body retrieval may be considered in regional centres with appropriate endovascular expertise, multidisciplinary discussion and access to surgical support. Awareness of venous thoracic outlet syndrome is important, as this may help guide the route of port placement.
Speakers
Authors
Authors

Miss Vanessa Di Tano - , Mr Riteesh Bookun - , Mr Michael Condous -