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Published on: July 19, 2018
[Extraction of embolised catheter fragments using percutaneous technique: report of 3 cases]
Insights
This study demonstrates the successful retrieval of broken central venous catheters from the heart using a basket catheter. This minimally invasive technique offers a safe solution for managing fractured catheter fragments within the cardiac chambers.
Area of Science:
- Cardiology
- Interventional Radiology
- Medical Device Technology
Background:
- Central venous catheters are essential for long-term venous access but are associated with complications.
- Catheter fracture and embolization into the heart pose a significant clinical challenge.
Observation:
- Three distinct cases involving fractured central venous catheters (IVH) migrating into the right atrium and pulmonary artery are presented.
- Patients experienced catheter fragmentation due to accidental cutting, self-extraction, or port detachment.
- Fragmented catheter pieces were successfully retrieved using a transvenous approach with basket catheters.
Findings:
- Basket catheters, guided by fluoroscopy, proved effective in retrieving intracardiac foreign bodies.
- The procedure involved transvenous insertion of an 8 Fr sheath introducer.
- Successful retrieval was achieved in all three presented cases, preventing further complications.
Implications:
- This technique offers a viable and effective method for managing fractured central venous catheter emboli.
- Minimally invasive retrieval reduces patient morbidity compared to open surgical procedures.
- Highlights the importance of careful catheter management and prompt intervention for embolized fragments.
Abstract:
Three cases are presented in which a basket catheter was used to retrieve broken central venous catheters successfully from the right side of the heart. Case 1: A 71-year-old female, in whom an IVH catheter was accidentally cut, and a fragment of which migrated into the pulmonary artery, was presented. Case 2: A 63-year-old male, fell into a restless state and pulled out the IVH catheter by himself, leaving a broken piece of catheter. Then, the catheter tip wandered into the right atrium. Case 3: In a 64-year-old male, it was found that the infusion port was detached from the catheter line for some unknown cause, and a chest X-ray film revealed migration of the catheter tip into the right atrium. We succeeded in removing the fragmented catheters by using basket catheters. They were inserted into the right heart transvenously, through a Fr. 8 sheath introducer (98cm long) under fluoroscopic control. We discussed the method and problems involved in removing intracardiac foreign bodies.
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