Mediport Embolism

A 78 year-old man was recently diagnosed with pancreatic cancer. A mediport has placed in the right subclavian vein for chemotherapy. Two days later, he developed the abrupt onset of aphasia which then resolved over the next two hours.

Mediport-o-gram. As contrast was injected into the mediport, the patient acutely became aphasic. Note that the mediport catheter is not in the subclavian vein, but the subclavian artery. The distal catheter travels to the brachiocephalic artery and then into the ascending aorta. The cathether lies right below the orifice of the left internal carotid artery. Thus, in this case, the misplaced mediport was the source of the proximal embolism. The patient's aphasia resolved over the next ten minutes.

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