Acute Thromboembolic Stroke Following Delayed Recognition of Port-A-Cath Misplacement into the Right Common Carotid Artery

Literature is scarce regarding the management of misplaced central venous catheters (CVCs) beyond the immediate post-procedure period. We present a 64-year-old female recently diagnosed with lymphoma who presented with left hemiparesis one week after a right internal jugular vein port-a-cath insertion. CT imaging demonstrated the port-a-cath was within the proximal right common carotid artery and thus the patient underwent a right neck exploration, removal and direct repair. Postoperatively, the patient’s neurological deficits resolved within 48 hours. This case demonstrates the harmful complications of delayed recognition of a misplaced CVC and the careful decision-making required towards surgical approach and potential pitfalls.