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Zhou H, Wang B, Pan J, Qiu C, Yu X, He Y, Zhu Q, Yu L, Wu Z, Li D, Zhang H. Percutaneous snare-retrieval of intracardiac thrombus under fluoroscopic and transesophageal echocardiography guidance: case report and systematic review. Front Cardiovasc Med 2023; 10:1127131. [PMID: 37229221 PMCID: PMC10203901 DOI: 10.3389/fcvm.2023.1127131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Intracardiac foreign bodies (IFB) are rare clinical conditions. There are now several reports on the percutaneous retrieval of IFB under fluoroscopy. However, some IFB are not radiopaque, and retrieval requires combined fluoroscopic and ultrasound guidance. We report the case of a bedridden 23-year-old male patient with T-lymphoblastic lymphoma treated with long-term chemotherapy. Ultrasound examination diagnosed a huge thrombus in the right atrium near the opening of the inferior vena cava which affected the patency of his PICC line. Ten days of anticoagulant therapy did not modify the thrombus size. Open heart surgery was not feasible because of the patient clinical condition. Snare-capture of the non-opaque thrombus was done from the femoral vein under fluoroscopic and ultrasound guidance with excellent outcomes. We also present a systematic review of IFB. We found out that percutaneous removal of IFBs is a safe and effective procedure. The youngest patient who received percutaneous IFB retrieval was 10 days old and weighed only 800 g, while the oldest patient was 70 years old. Port catheters (43.5%) and PICC lines (42.3%) were the most commonly found IFBs. Snare catheters and forceps were the most commonly used instruments.
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Affiliation(s)
- Huaji Zhou
- Department of Vascular Surgery, The NO.1 People’s Hospital of Pinghu, Jiaxing, China
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bing Wang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Pan
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinyu Yu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yangyan He
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qianqian Zhu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Yu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Lyu T, Cao S, Wang J, Song L, Tong X, Zou Y. Endovascular Removal of Foreign Bodies: Single Center Experience. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AbstractCatheter rupture or displacement is a serious and rare complication of central venous catheterization, with an incidence of approximately 1%. Once the intravascular foreign body is found, it should be removed as soon as possible. This study investigated the safety and efficacy of endovascular techniques for the removal of intravascular foreign bodies. This was a retrospective analysis of 23 patients with intravascular foreign bodies admitted to our hospital from January 2009 to June 2019 summarizing the types and locations of foreign bodies and the removal techniques. Overall Twenty-three cases of intravascular foreign bodies were successfully treated with endovascular techniques, for a technical success rate of 100%. The types of foreign bodies included 14 infusion port catheters (60.9%), 6 peripherally inserted central catheters (26.1%), 2 temporary deep vein catheters (8.7%), and 1 intravenous stent (4.3%). The most common orientation of foreign body displacement was one end of the foreign body in the inferior vena cava and the other end in the right atrium (14/23, 60.9%). In terms of technique, all patients underwent removal procedures with only one venous access point. The operative time ranged from 6 to 153 min, with an average of 28.7 min. This study preliminarily demonstrates the safety and efficacy of percutaneous interventional intravascular foreign body removal. Endovascular techniques are minimally invasive and reliable and can be used to safely and effectively remove intravascular foreign bodies.
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Leite TFDO, Pazinato LV, Bortolini E, Pereira OI, Nomura CH, Filho JMDML. Endovascular removal of intravascular foreign bodies: A single-center experience and literature review. Ann Vasc Surg 2021; 82:362-376. [PMID: 34936892 DOI: 10.1016/j.avsg.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/18/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe causes, clinical signs, experience and endovascular techniques for extraction of intravenous foreign bodies (IFB) and literature review. METHODS This retrospective study was based on data collected from the medical records of 51 consecutive patients (26 women and 25 men) treated from July 2007 to May 2020 at a single quaternary center in Brazil and case series with data, published in the literature since 2000 on IFB removal, of at least five patients. The average patient age was 43.54 years (range, 2 months to 84 years). The different retrieval method using the following was used in the procedure: gooseneck snare, guidewire, balloon, and custom snares. RESULTS The retrieval process rate was 100%. Thirty-one port-a-caths, six guidewires, four double lumens, three permcaths, three Shiley® catheters, one intra cath, two peripherally inserted central catheters, and one stent were extracted. The locations where the IFBs were most frequently trapped were the right atrium (39.2%), the pulmonary artery (17.64%), the superior vena cava (13.72%), and the right ventricle (16.12%). Single venous access was used in 67.07% of the patients. Femoral access, which was the most commonly used approach, was used in 85.71% of the patients. The loop was used in 64.70% of the patients. A fractured catheter was the main IFB in 60.76% of the cases (31 patients). Only one complication related to the extraction of an IFB was noted in a single patient who suffered from atrial fibrillation (1.96%). The 30-day mortality rate was zero. CONCLUSION Percutaneous IFB removal should be considered as an alternative for the treatment and retrieval of IFBs because it is a minimally invasive procedure that is relatively simple, safe, and has low complication rates.
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Affiliation(s)
| | - Lucas Vatanabe Pazinato
- Interventional Radiology Unit, Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Edgar Bortolini
- Interventional Radiology, Radiology Department, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil
| | - Osvaldo Ignacio Pereira
- Interventional Radiology Unit, Department of Radiology, University of São Paulo Medical School, São Paulo, Brazil
| | - Cesar Higa Nomura
- Interventional Radiology, Radiology Department, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil
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Sarti G, Quassone P, Tarotto L, Tamburrini S, Arienzo F, Santini G. Recovery of a broken PICC migrated in cardiac chambersan endovascular approach. Radiol Case Rep 2021; 16:874-878. [PMID: 33552344 PMCID: PMC7850964 DOI: 10.1016/j.radcr.2021.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 11/22/2022] Open
Abstract
Complications related to the placement of a peripherally inserted central catheter are a common phenomenon and they can lead to acute complications which must be treated in an emergency regime. The aim of this study was to describe cases in their most practical and technical aspect, especially in complicated conditions. This was a descriptive case report of a 64 years old female patient who presented with a fractured peripherally inserted central catheter, migrated into the right heart chambers and inferior vena cava, and how the team arranged for its recovery by endovascular technique, in a frail patient who could not undergo to open surgery.The procedure was completed without any complications. The use of the endovascular technique allows a recovery of the foreign body in a short time, essential for a life-saving procedure; the interventional radiological approach allows less invasiveness in fragile patients and shorter hospitalization times.
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Affiliation(s)
- Giuseppe Sarti
- Vascular and Interventional Unit-P.O. Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Pasquale Quassone
- Radiology Department, University of Campania "L. Vanvitelli", piazza Luigi Miraglia, 80138, Naples
| | - Luca Tarotto
- Vascular and Interventional Unit-P.O. Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | | | - Francesco Arienzo
- Vascular and Interventional Unit-P.O. Ospedale del Mare, ASL NA1 Centro, Naples, Italy
| | - Gianpaolo Santini
- Vascular and Interventional Unit-P.O. Ospedale del Mare, ASL NA1 Centro, Naples, Italy
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Izumi Y, Ikeda S, Kitagawa A, Imaeda Y, Yamada T, Hagihara M, Ota T, Ishiguchi T, Suzuki K. Percutaneous Retrieval of a Misinserted Pigtail Catheter Straightener during Infra-Renal Abdominal Aortic Stenting: A Case Report. INTERVENTIONAL RADIOLOGY 2020; 5:145-149. [PMID: 36284757 PMCID: PMC9550410 DOI: 10.22575/interventionalradiology.2020-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/12/2020] [Indexed: 11/19/2022]
Abstract
Percutaneous retrieval of an intravascular foreign body is a minimally invasive technique. Using cone-beam computed tomography and the lateral grasp technique, we successfully retrieved a pigtail catheter straightener that had been misinserted into the right common iliac artery. Some examples of catheter straightener retrieval have been reported; however, it is important to take care not to accidentally insert a catheter straightener into a vessel via an angiographic sheath.
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Affiliation(s)
| | - Shuji Ikeda
- Department of Radiology, Aichi Medical University
| | | | - Yusuke Imaeda
- Department of Vascular Surgery, Aichi Medical University
| | - Tetsuya Yamada
- Department of Vascular Surgery, Aichi Medical University
| | | | - Toyohiro Ota
- Department of Radiology, Aichi Medical University
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Rossi UG, Rollandi GA, Ierardi AM, Valdata A, Pinna F, Pescatori LC, Gallieni M, Carrafiello G, Cariati M. Materials and techniques for percutaneous retrieval of intravascular foreign bodies. J Vasc Access 2018; 20:87-94. [PMID: 29976095 DOI: 10.1177/1129729818785051] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The presence of an intravascular foreign body represents a well-known risk of serious complications. While in the past surgical removal of intravascular foreign body was the most common intervention, nowadays a percutaneous approach in the retrieval of an intravascular foreign body is widely accepted as the first-line technique. In the literature, many case reports describe different techniques and materials. This article summarizes and illustrates the main materials and techniques currently applied for percutaneous retrieval of intravascular foreign body, providing a simplified tool with different interventional possibilities, adaptable to different clinical situations.
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Affiliation(s)
- Umberto G Rossi
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | - Gian Andrea Rollandi
- 2 Department of Diagnostic Imaging, Radiology Unit, Galliera Hospital, Genova, Italy
| | - Anna Maria Ierardi
- 3 Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Paolo Hospital, Milan, Italy
| | - Alessandro Valdata
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | - Francesco Pinna
- 1 Department of Diagnostic Imaging, Interventional Radiology Unit, Galliera Hospital, Genova, Italy
| | | | - Maurizio Gallieni
- 5 Nephrology and Dialysis Unit, ASST Santi Paolo and Carlo Hospital, Milan, Italy
| | - Gianpaolo Carrafiello
- 3 Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Paolo Hospital, Milan, Italy
| | - Maurizio Cariati
- 6 Department of Diagnostic Science, Radiology and Interventional Radiology Unit, ASST Santi Paolo and Carlo, San Carlo Borromeo Hospital, Milan, Italy
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