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Fig. 6 | Insights into Imaging

Fig. 6

From: Complications of central venous port systems: a pictorial review

Fig. 6

Extravascular malpositioning. a Intraoperative fluoroscopy shows the catheter projecting above the clavicles, which is not in line with an intravascular position (in the brachiocephalic vein). b Port system was subsequently used for several weeks. Follow-up chest radiograph shows increasing pleural effusions. Malposition of the catheter was reported. c, d Subsequently a flow confirmation study was performed, which shows extravascular collection of contrast (star) and some contrast material reflux into the internal jugular vein (large arrow), the subclavian vein (small arrow), as well as along the catheter into cervical veins (arrowhead). The catheter has an extravascular course and perforated the contralateral venous angle, with chemotherapy infusions partly entering the venous systems, partly filling up the pleural space

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