Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 57 12 2020 06 13 686 689 Wala Ben Kridis Department of Medical Oncology, Habib Bourguiba University Hospital, Sfax, Tunisia. Nabil Toumi Department of Medical Oncology, Habib Bourguiba University Hospital, Sfax, Tunisia . Afef Khanfir Department of Medical Oncology, Habib Bourguiba University Hospital, Sfax, Tunisia . 2019 03 28 2020 04 24 A totally implantable venous access port (TIVAP) plays a crucial role in the treatment of patients in oncology. Catheter fracture is a serious complication with an estimated incidence of 0, 1% - 1%. The objective of this systematic review is to analyze the mechanism of TIVAP fracture to make physicians aware of this fatal entity. A search of the literature between 1980 and 2019 was conducted using PubMed, Ovid, MEDLINE, and Cochrane Systematic Review databases. The search identified 18 case reports and 8 retrospective studies. Fracture of the middle part of the catheter may be induced by constant compression of the catheter between the first-rib and clavicle, which is called the pinch-off syndrome. Catheter fracture at the port-catheter junction may be caused by extrinsic compression near the port-catheter junction combined with material fatigue due to repeated bending of the catheter with shoulder movement. There is no specific cause for the fracture of a catheter tip. An annual chest X-ray is recommended for the early detection of TIVAP catheter fracture. Percutaneous endovascular retrieval of a dislodged Port-A catheter is both safe and effective. https://acta.tums.ac.ir/index.php/acta/article/view/7819 https://acta.tums.ac.ir/index.php/acta/article/download/7819/5347