The Catheter Pinch-Off Syndrome (CPOS) may involve a percutaneous intravascular catheter inserted into the subclavian vein. It is caused by compression of the catheter as it runs between the first rib and the clavicle.


Features of the CPOS:

(1) associated with catheters inserted medial to the midclavicular line

(2) intermittent mechanical occlusion, with (a) resistance to flushing or infusion and/or (b) difficulty in aspirating blood

(3) relief of the occlusion by either (a) rolling the ipsilateral shoulder, and/or (b) raising the ipsilateral arm

(4) radiographic narrowing of the catheter lumen as it travels between the first rib and the clavicle


Prevention: Insertion of the catheter lateral to the midclavicular line.


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