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[Nonsurgical retrieval of intra-cardiovascular catheter fragments]
1Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Insights
Transvenous retrieval of migrated intravascular catheter fragments, often used for total parenteral nutrition, is a safe and effective procedure. This minimally invasive technique successfully removed fragments from the pulmonary artery and right atrium in all cases.
Area of Science:
- Cardiovascular medicine
- Interventional radiology
- Medical device retrieval
Context:
- Catheter fragments can migrate within the cardiovascular system, posing a risk to patients.
- Total parenteral nutrition (TPN) catheters are frequently implicated in such migration events.
- Previous retrieval methods may have been limited or associated with complications.
Purpose:
- To describe a successful transvenous retrieval technique for intravascular migrated catheter fragments.
- To evaluate the safety and efficacy of a modified basket-type grasping forceps for fragment removal.
- To establish a reliable, minimally invasive option for managing this clinical complication.
Summary:
- Six cases of migrated intra-cardiovascular catheter fragments were successfully retrieved using a transvenous approach.
- Fragments originated from catheters used for total parenteral nutrition and were located in the pulmonary artery or right atrium.
- A modified basket-type grasping forceps inserted percutaneously via major veins (subclavian, femoral, basilic) was utilized.
- The retrieval procedure was performed without any clinical complications in all six patients.
Impact:
- This noninvasive maneuver offers a simple, safe, and reliable method for removing migrated catheter fragments.
- The technique can be promptly implemented, reducing patient risk and potential for further complications.
- It is considered a method of choice for managing intravascular migrated catheter fragments, particularly those from TPN lines.
Abstract:
Migrated intra-cardiovascular fragments from broken catheters were retrieved transvenously in 6 cases. In all of these cases, the catheters had been used for total parenteral nutrition. The catheter fragments were lodged in the pulmonary artery in 3 cases and in the right atrium in the others. A basket-type grasping forceps modified for this retrieval technique was inserted via the subclavian vein, femoral vein or basilic vein percutaneously. The migrated catheter fragments were removed successfully without any clinical complications in all 6 cases. Appropriate evaluation of the lodging site and length of the fragment, and careful examination of general condition should be carried out prior to this procedure. This noninvasive maneuver is simple, safe and reliable, and can be promptly. It is considered to be a reliable method of choice in cases of migrated catheter fragment.