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Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

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

Shikha Sood¹, S Srinivasan¹

¹Department of Radiodiagnosis, Indira Gandhi Medical College (IGMC), Shimla 171001, Himachal Pradesh, India.

Radiology Case Reports

|January 3, 2022

Summary

This summary is machine-generated.

A new two-step technique safely retrieves lost central venous catheters from pulmonary arteries. This endovascular approach uses a SIM 1 catheter and loop snare, offering a viable solution for inaccessible devices.

Keywords:

Fr, French IFB, Intravascular foreign body IR, Intervention radiology IVC, Inferior vena cava Intravascular foreign body (IFB)PICC, Peripherally inserted central catheter Peripherally inserted central catheter (PICC)SIM, Simmons VAD, Vascular access device Vascular access device (VAD)

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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.