Retrieving embolized peripherally inserted central catheter - A novel two step technique

Area of Science:

• Interventional Radiology
• Cardiovascular Surgery
• Medical Device Retrieval

Background:

• Peripherally inserted central catheters (PICCs) can embolize to pulmonary arteries, posing a significant retrieval challenge.
• Traditional methods for retrieving embolized lines are often complex or carry high risks.
• Novel endovascular techniques are needed for safe and effective removal of misplaced vascular access devices.

Observation:

• A 17-year-old female with osteosarcoma experienced PICC embolization to a left pulmonary artery segmental branch.
• A two-step percutaneous endovascular technique was successfully employed for retrieval.
• The technique involved using a SIM 1 catheter to reposition the PICC into the inferior vena cava, followed by loop snare removal.

Findings:

• The novel two-step technique successfully retrieved the embolized PICC without complications.
• The SIM 1 catheter facilitated repositioning, and the loop snare enabled secure grasping and removal.
• This method proved safe and efficacious for retrieving a peripherally inserted central catheter with inaccessible free ends.

Implications:

• This technique offers a safe and effective alternative for retrieving embolized vascular access devices, particularly when free ends are not available.
• Interventional radiologists can consider this approach for managing complex cases of catheter embolization.
• Successful retrieval minimizes risks associated with retained foreign bodies and potential complications.