Superior vena cava erosion and perforation

Francesca Ratti, Michele Paganelli, Marco Catena, Luca Aldrighetti

Research output: Chapter in Book/Report/Conference proceedingChapter


The most important predisposing factor to caval perforation is prolonged contact of the end of the catheter against the vein wall, as occurs more frequently in cases of catheter insertion through collateral vessels of the left innominate vein. The initial clinical manifestations of vascular perforation include cardiopulmonary symptoms (chest pain or dyspnea) or radiographic evidence of a new or rapidly progressive pleural effusion. The curved tip sign usually precedes other clinical and radiographic signs of perforation. Recognition of a gentle curve of the catheter tip should prompt readjustme ntor replacement of its position to avoid vessel perforation, which may result in hydrothorax and pneumothorax, hydromediastinum, and pericardial effusion, all potentially life-threatening complications. Once diagnosed, the catheter must be removed promptly.

Original languageEnglish
Title of host publicationTotally Implantable Venous Access Devices: Management in Mid- and Long-Term Clinical Setting
PublisherSpringer-Verlag Italia s.r.l.
Number of pages4
ISBN (Print)9788847023734, 9788847023727
Publication statusPublished - Jan 1 2012


  • Curved-Tip sign
  • Erosion
  • Hydrothorax
  • Implantable venous port
  • Mediastinal effusion
  • Perforation
  • Superior vena cava

ASJC Scopus subject areas

  • Medicine(all)


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