Fluoroscopy-guided transfemoral pigtail catheter repositioning of malpositioned totally implantable venous access port catheters: a retrospective single-center study.
- 1Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract
Catheter malposition is a recognized complication of totally implantable venous access ports (TIVAPs). Removal or reimplantation may be unnecessarily invasive when the catheter remains patent, whereas untreated malposition may cause thrombosis, dysfunction, or infusion-related complications. Evidence regarding pigtail catheter repositioning remains limited. This study reviews 39 cases of TIVAP catheter malposition treated using a transfemoral pigtail catheter technique. This retrospective case series included 39 patients with imaging-confirmed TIVAP catheter malposition treated between September 2018 and October 2025. Eligible catheters were patent and functional without occlusion; patients with catheter dysfunction or those managed using other repositioning methods were excluded. Under fluoroscopic guidance, a 5-F pigtail catheter was introduced through the femoral vein to redirect the catheter tip into the intended central venous position. The right internal jugular vein was the most common malposition site (25/39, 64.1%). Initial technical success was achieved in all patients, with a mean procedure duration of 13.64±5.02 minutes. No immediate procedure-related complications were documented. Recurrent malposition occurred in 2 patients during a mean follow-up of 3.9±3.7 months (range, 2-14 months). Fluoroscopy-guided transfemoral pigtail catheter repositioning is technically feasible for selected patients with a functioning, non-occluded malpositioned TIVAP and may avoid immediate catheter replacement or surgical revision.
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BibTeX
@article{yang2026fluoroscopyguided,
title = {{Fluoroscopy-guided transfemoral pigtail catheter repositioning of malpositioned totally implantable venous access port catheters: a retrospective single-center study.}},
author = {Zhouding Yang and Yishu Ma and Jiajia Zhang and Yaozhen Ma and Meipan Yin and Ling Wang and Chunxia Li and Gang Wu},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = sep,
doi = {10.21037/qims-2026-0991},
url = {https://europepmc.org/article/MED/42997951},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Fluoroscopy-guided transfemoral pigtail catheter repositioning of malpositioned totally implantable venous access port catheters: a retrospective single-center study.
AU - Zhouding Yang
AU - Yishu Ma
AU - Jiajia Zhang
AU - Yaozhen Ma
AU - Meipan Yin
AU - Ling Wang
AU - Chunxia Li
AU - Gang Wu
PY - 2026
DA - 2026/09/30
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-0991
UR - https://europepmc.org/article/MED/42997951
AB - Catheter malposition is a recognized complication of totally implantable venous access ports (TIVAPs). Removal or reimplantation may be unnecessarily invasive when the catheter remains patent, whereas untreated malposition may cause thrombosis, dysfunction, or infusion-related complications. Evidence regarding pigtail catheter repositioning remains limited. This study reviews 39 cases of TIVAP catheter malposition treated using a transfemoral pigtail catheter technique. This retrospective case series included 39 patients with imaging-confirmed TIVAP catheter malposition treated between September 2018 and October 2025. Eligible catheters were patent and functional without occlusion; patients with catheter dysfunction or those managed using other repositioning methods were excluded. Under fluoroscopic guidance, a 5-F pigtail catheter was introduced through the femoral vein to redirect the catheter tip into the intended central venous position. The right internal jugular vein was the most common malposition site (25/39, 64.1%). Initial technical success was achieved in all patients, with a mean procedure duration of 13.64±5.02 minutes. No immediate procedure-related complications were documented. Recurrent malposition occurred in 2 patients during a mean follow-up of 3.9±3.7 months (range, 2-14 months). Fluoroscopy-guided transfemoral pigtail catheter repositioning is technically feasible for selected patients with a functioning, non-occluded malpositioned TIVAP and may avoid immediate catheter replacement or surgical revision.
SN - 2223-4292
SN - 2223-4306
ER -