Echocardiographic and Angiographic Guided Removal of a Fractured Central Venous Access Port Using Snare Loop

Alizadehasl, Azin; Zohrian, Fatemeh; Abdi, Seifolah; Bezanjani, Freidoon Noohi; Mohebbi, Bahram; Mohamadifar, Arezoo; Ziyaeifard, Mohsen; Azarfarin, Rasoul; Valizadeh, Solmaz

doi:10.5812/mca.99584

Cited by 2 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most common location of the fracture described in the literature is the anastomotic site between the ports and catheter, likely due to the constant shear stress at that location [ 6 ]. Dislodged catheter fragments in the heart may lead to multiple complications, most commonly infective endocarditis, necessitating emergent removal [ 7 ]. In a series of 92 patients by Cheng et al with dislodged CVPCs, the most common location of dislodgement was the SVC-RA junction [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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

Shah¹,

Radadiya²,

Velamakanni³

et al. 2022

Cureus

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Shah¹,

Radadiya²,

Velamakanni³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Although the incidence of embolic events, such as intravascular foreign bodies (IVFB), related to catheters in children has not been clearly identified, the rate of catheter embolization was found to be 0.67% in one study 4 . Because of the rare, fatal complications (myocardial perforation, tamponade, arrhythmia, infective endocarditis, etc) that can be seen with the embolization of IVFB to the heart and pulmonary arteries, it is preferable to extract the foreign material 5–7 …”

mentioning

confidence: 99%

“…4 Because of the rare, fatal complications (myocardial perforation, tamponade, arrhythmia, infective endocarditis, etc) that can be seen with the embolization of IVFB to the heart and pulmonary arteries, it is preferable to extract the foreign material. [5][6][7] Of the reported cases in the literature, all were asymptomatic after extraction. [8][9][10][11][12] Historically, in the 1950s, surgical treatment was seen as the first choice in the initial cases.…”

mentioning

confidence: 99%

Percutaneous Transcatheter Retrieval of Central Venous Port Fragments in Pediatric Patients; A Single-center Experience From the Pediatric Cardiology Department

Duman,

Aykan,

Ertuğrul

et al. 2023

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Background: Split/fracture and embolization of central venous/shunt catheters are rare but serious complications in children. Percutaneous retrieval of intravascular foreign bodies is an important minimal invasive treatment. This study is aimed to represent our largest pediatric sample experience till now of 17 years from a single institution. Another aim is to compare the results regarding the removal or leaving in place of embolized or ruptured intravascular or cardiac venous catheter parts in children. Patients and Methods: A total of 26 cases were included in this study. Any pediatric patient with normal coagulation parameters and a fractured catheter fragment was included in this study. Other intravascular foreign bodies related to interventional devices and/or pacemaker/implantable cardiac defibrillator leads were excluded from this study. Results: Twenty-six patients, of whom 25 had oncologic diseases and 1 had a ventriculoatrial shunt, were included. The median age was 83.5 months (between 20 mo and 18 y) at treatment. Superior vena cava (9 cases), followed by the right atrium (5 cases), were the most two common sites of embolization for cardiovascular foreign bodies. The success rate of percutaneous retrieval was 92.3% in all patients. There were neither complications nor deaths. The retrieval technique revealed a predisposition for extraction through the femoral vein (96.1%) and using snare techniques (100%). Additional catheters like pigtail, National Institutes of Health, or ablation catheters were used for stabilization in selective cases in which the permanent central venous fragments stuck to the vessels. A tractional maneuver and capturing the ruptured material in the middle were other trick points for successful retrieval. Patients were asymptomatic in 76.9% of cases (20/26). Conclusion: Percutaneous retrieval of cardiovascular foreign bodies is a reasonable, safe, and effective way in children when the catheter fragments are free and mobile. It should be considered the preferred treatment option instead of surgery. In patients where catheter fragments are stuck and are adherent to vessels, it could be left, and followed up by anticoagulation. Novel techniques accompanied by an experienced team could be helpful in difficult cases.

show abstract

Echocardiographic and Angiographic Guided Removal of a Fractured Central Venous Access Port Using Snare Loop

Cited by 2 publications

References 5 publications

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

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

Percutaneous Transcatheter Retrieval of Central Venous Port Fragments in Pediatric Patients; A Single-center Experience From the Pediatric Cardiology Department

Contact Info

Product

Resources

About