Successful percutaneous transvenous retrieval of intravascular fractured port catheter: a single center experience

"Trap technique": A new multimodal approach for the treatment of intracardiac foreign body retrieval

In medical practice, the retrieval of intravascular foreign bodies (IFBs) represents a challenge and often requires a multidisciplinary approach. We report a case of a 65-year-old male patient with a metallic guide wire extended from the right subclavian artery to the left ventricle. An interventional radiology team employed the "trap technique", with a combination of a retrieval device and angiographic catheters, which results crucial in this case. Proper device management and imaging assessment are essentil to the successful retrieval of IFBs. Further research is warranted to refine IFB retrieval techniques and evaluate long-term outcomes.

Cardiac Migration of Chemoport Catheter-A Rare Complication: Review of Literature and Our Experience

Chemoport devices are commonly used for the administration of chemotherapeutic medication in cancer patients and can also be used for total parenteral nutrition and long term intravenous therapy. They are usually inserted through the internal jugular vein or the subclavian vein. The common complications of the procedure include pneumothorax, bleeding, arrhythmia and venous thrombosis. One of the rare complications of chemoport is catheter fracture/dislodgement and subsequent migration, with an incidence of 0.1-2.1%. Other rare complications are vascular erosion and embolization, vocal cord palsy and mediastinal hematoma. The aims and objectives are as follows: (1) to report a rare case of chemoport catheter migration between the right ventricle and pulmonary artery and (2) to review the literature on the rare complication of cardiac migration of a chemoport. A 56-year-old lady, known case of carcinoma right breast, post modified radical mastectomy was advised adjuvant chemotherapy. A chemoport catheter was placed in the right internal jugular vein and was positioned over the left upper chest. The 1st cycle of chemotherapy was given through chemoport and was uneventful. On the second chemotherapy schedule, catheter dysfunction was found. For the same, she was evaluated with chest radiography, which showed the migrated catheter in the heart. The migrated catheter was retrieved by snare technique using percutaneous transvenous route. The procedure was uneventful. The literature on the topic was reviewed. Chemoport catheter fracture or dislodgement and its subsequent cardiac migration are a rare but serious complication. High index of suspicion in case of catheter dysfunction, early detection by chest radiography, and timely multi-disciplinary intervention is crucial.

Surgical removal of a peripheral venous catheter fragment in the heart in a preterm infant

Peripheral venous catheter fracture with cardiovascular embolization is a rare but potentially serious complication. Herein, we report a case of peripheral venous catheter fracture with embolization in right ventricle in a preterm infant. The catheter fragment was successfully removed by surgical procedure via median sternotomy under cardiopulmonary bypass(CPB).We hope this case will increase awareness of this rare complication and improve cannulation safety.

Successful Removal of a Fractured Desilets-Hoffman Sheath in a Patient With a Loop Arteriovenous Graft: Balloon-Supported Retrieval Technique

INTRODUCTION

While a Desilets-Hoffman sheath rarely fractures, when it does, the presence of an intravenous foreign body can cause various complications.

CASE PRESENTATION

A 74-year-old woman receiving hemodialysis for end-stage renal disease via a left forearm arteriovenous graft (AVG) was referred to the interventional radiology department following thrombotic occlusion of the AVG. A corrective procedure was initiated, and the 7F Desilets-Hoffman sheath fractured after the purse-string suture. A .035-inch guidewire was passed through the fractured sheath, and a 3.0-mm x 60-mm balloon catheter was inflated, allowing for the successful removal of the sheath fragment without complications.

CONCLUSION

The fractured Desilets-Hoffman sheath was successfully removed in a patient with a loop arteriovenous graft using balloon-supported retrieval technique.

Percutaneous Retrieval of Dislodged Chemo Port Catheter With Inaccessible Tips by a Simplified Technique

Central venous port catheters (CVPCs) are commonly employed for long-term chemotherapy. One of the rare complications associated with CVPCs is catheter fracture and further embolization of the fragmented segment into the heart. The most common site of embolization is the superior vena cava-right atrium (RA) junction. However, infrequently, the catheter may embolize further distally into the right ventricle (RV) and beyond making the fragmented tips difficult to access directly with a snare. Here, we report a case wherein both the catheter tips were lodged in the RV cavity forming a loop in the RA. This necessitated the use of a modified technique to retrieve the fragment percutaneously.

Retrieval of fragmented peripherally inserted central catheter (PICC) with a double transfemoral access technique

Retrieval of central venous catheters fragments often puts us in front of different situations. Having more techniques available for strategic planning of the procedure is important. The authors propose the simultaneous use of two different approaches for the recovery of a CVC fragment from the pulmonary artery.