“Internal Mammary Vein Cannulation during Port-o-Cath Insertion”

We read with great interest, the case report by Dr. Harish and Dr. Madhu regarding, “Inadvertent port: catheter placement in the azygous vein.”[1] The authors aptly point out that this is an uncommon occurrence during central venous access. Its diagnosis is difficult with the fluoroscopy in the anterioposterior (AP) position. Indeed, even chest X-rays in the AP projection can be of little value. We have included a case of internal mammary vein cannulation during Port-o-Cath insertion in our textbook, Venous and Lymphatic Diseases.[2] We have found that prompt diagnosis can be achieved with a venogram to confirm position. Furthermore, the lateral chest X-ray is often beneficial in delineating the course of the catheter. Once again, we appreciate the authors for sharing their case.

• References

• 1 Harish K, Madhu YC. Inadvertent port: catheter placement in the azygous vein. Int J Angiol 2012; 21: 103-106
• 2 Dieter RS, Kuzycz GB, Dieter RA. Venous and Lymphatic Diseases. New York: McGraw-Hill; 2011. ; Chap 16:205