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Percutaneous retrieval of intravascular foreign body in children: a case series and review
Lucas Vatanabe Pazinato1, Tulio Fabiano de Oliveira Leite2, Edgar Bortolini2
1Interventional Radiology, Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil.
Insights
Percutaneous retrieval of intravascular foreign bodies is a safe and effective treatment for children. This minimally invasive technique successfully removes embolized catheter fragments with a high success rate and low complication rate.
Area of Science:
- Pediatric Interventional Cardiology
- Vascular Surgery
- Medical Device Retrieval
Background:
- Percutaneous retrieval of intravascular foreign bodies is an increasingly utilized treatment.
- Catheter fragments are common iatrogenic intravascular foreign bodies in children.
- Embolization of medical devices poses significant risks to pediatric patients.
Purpose of the Study:
- To report a single-center experience with percutaneous retrieval of intravascular embolized catheter fragments in children.
- To review the literature on percutaneous retrieval of intravascular foreign bodies in pediatric patients.
- To evaluate the safety and efficacy of this technique in a pediatric population.
Main Methods:
- A retrospective analysis of 14 pediatric cases of percutaneous retrieval of intravascular foreign bodies.
- A comprehensive literature search of MEDLINE for case reports and series involving children and iatrogenic catheter fragments or guidewires.
- Statistical analysis of combined data from institutional cases and literature review.
Main Results:
- Port catheter fragments and peripherally inserted central catheters (PICCs) were the most common embolized foreign bodies.
- The pulmonary artery was the most frequent site of embolization (44.1%).
- Percutaneous retrieval via the femoral vein using snare techniques achieved a 96.6% success rate with a low complication rate (1.1%).
Conclusions:
- Percutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children.
- This minimally invasive approach should be considered the preferred treatment option for pediatric patients with intravascular foreign bodies.
- The high success rate and low complication profile support the widespread adoption of this technique in pediatric care.
Background:
Percutaneous retrieval of intravascular foreign bodies has recently increased as a treatment option.
Purpose:
To report our single-center experience of the percutaneous retrieval of 14 intravascular embolized catheter fragments in children and to conduct a literature review.
Material And Methods:
MEDLINE databases were searched for case reports and series including children and iatrogenic catheter fragments or guidewires retrieved through percutaneous techniques. We also conducted a retrospective analysis of 14 cases from our institution over a 14-year period. A total of 27 studies were selected comprising 74 children, plus our 14 unpublished cases. Statistical analyses were performed using Microsoft Excel version 2016.
Results:
Port catheter fragments and peripherally inserted central catheters (PICCs) were the most embolized foreign bodies and the pulmonary artery was the most common site of embolization in 44.1% of cases. Analysis of the retrieval technique demonstrated a preference for extraction through the femoral vein (81.7%) and using snare techniques (93.5%). The success rate of percutaneous retrieval was 96.6% with only 1.1% of procedure-related complications. Patients were asymptomatic in 77.2% of cases, presented septic complications in 2.3%, and no deaths were reported. Median fluoroscopy time was 10 min (range = 1.7-80 min) and median procedure length was 60 min (range = 35-208 min).
Conclusion:
Percutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children and should be considered the preferred treatment option.
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