- Pneumothorax due to incorrect puncture with aspiration of air as an indication of lung injury → X-ray control and clinical monitoring, physician remains with the patient, if necessary, placement of a chest drain (depending on the clinic).
- Intraoperative air embolism → Attempt to aspirate air via an existing catheter if present. Otherwise, no specific therapy possible.
- Inability to introduce the port tube below the clavicle → Insertion of a larger dilation catheter for pre-dilation.
- Arterial mispuncture → Consistent compression for at least 5 minutes locally.
- Port catheter cannot be advanced → Control under fluoroscopy with injection of contrast medium through the existing needle, then advance the wire.
- Lack of puncturability → Termination of the operation. Alternative: Placement of a cephalic port.
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intraoperative complications
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postoperative complications
- Delayed pneumothorax → Chest drainage placement
- Port occlusion → Attempt to unblock with heparin, if unsuccessful, attempt flushing with urokinase or alteplase
- Catheter dislocation → Administration of contrast medium and, if necessary, interventional radiological repositioning attempt via the femoral vein, alternatively surgical revision
- Catheter fractures and leaks (catheter pinched between the first rib and clavicle) → Port explantation
- Port disconnection with extravasation → Surgical revision
- Port infection (0.8-7.5%) → Port explantation (an exposed port is always considered infected)
- Postoperative stroke due to arterial misplacement → Catheter removal
- Subclavian bleeding due to arterial mispuncture → Local pressure dressing, possibly angio-CT control in case of severe arterial bleeding, possibly local surgical revision under anesthesia.
- Thrombosis of the subclavian vein → Port removal not necessarily indicated