Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies

Fisher, R. Darryl; Ferreyro, Roque

doi:10.2214/ajr.130.3.541

Cited by 289 publications

(147 citation statements)

References 36 publications

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“…Despite embolization frequently being asymptomatic, catheter fragments have been associated with a number of complications such as arrhythmias, pulmonary embolism, thrombosis, sepsis, and cardiac perforation [19,20]. Given the potential for such complications, patients should be referred to interventional cardiology or radiology, and the embolized catheters retrieved by using interventional endovascular techniques as was done in our study [18].…”

Section: Discussionmentioning

confidence: 99%

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Shankar

Jadhav

Ravindra

et al. 2016

Indian J Surg Oncol

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Children with malignancy require venous access that is reliable, safe and compliant on a long-term basis. There is little data available on utilization of totally implantable venous access devices (TIVAD) for long term chemotherapy in children in an Indian setting [1]. We report our long-term follow-up results of utilization of totally implantable venous access devices for long-term chemotherapy in children. This was a retrospective analysis of 122 children requiring longterm chemotherapy done between January 2008 and December 2013. Data collected included primary disease process, type of port, site of insertion, intraoperative events, early and late postoperative complications, and issues with utilization, maintenance and removal. 127 ports were placed in 122 children. The follow up ranged from 16 to 50 months. Internal jugular vein was accessed in 96.8 % of cases (123/127). Majority of children (61 %) had hematological malignancy. Early complications occurred in 5 children. Late complications occurred in 18 children which included port pocket infection in 3, port site skin issues in 5, catheter related issues in 3, venous thrombosis in 2 and catheter related bacteremia in 5 children respectively. Only 10 children have been lost to follow-up either due to death or discontinuation of treatment and rest are on follow up. Totally implantable venous access devices usage is safe and reliable for access needs in children for longterm chemotherapy. Their low complication and low cost maintenance should increase their utilization in children requiring long-term chemotherapy. Chemoport placement in children with hematological malignancy can be carried out safely without much impact on complication rates. Though management and compliance of children with malignancy has improved; critical analysis and standardization of port system care through prospective trials are necessary to reduce the morbidity and for cost analysis in these children.

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Section: Discussionmentioning

confidence: 99%

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Shankar

Jadhav

Ravindra

et al. 2016

Indian J Surg Oncol

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“…10 The neurointerventional and cardiac literature also includes several reports of foreign bodies, including epicardial pacing wires, catheter tips, and detachable balloons. 1,3,6,8,11 Given the size of foreign objects relative to vessel caliber, most objects embolize into the distal ICA and middle cerebral artery (MCA) branches. It is exceedingly rare for a foreign body to become lodged in the CCA because of the larger size of that artery.…”

Section: Discussionmentioning

confidence: 99%

“…Endovascular devices for foreign body retrieval have also continued to improve, including helical baskets, loop snares, Fogarty catheters, "hook" guide wires, bronchoscopic forceps, and myocardial biopsy catheters. 3 Koseoglu et al 7 described their experience using the goose neck snare in 15 patients for the successful retrieval of iatrogenic foreign bodies, including a microcoil in the left MCA and a fragmented catheter in the carotid artery. Using a stone basket retriever, Travelli and Cogbill 12 successfully extracted a 4-Fr diagnostic catheter fragment from the right CCA.…”

Section: Discussionmentioning

confidence: 99%

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Meyers¹,

Sorkin

Shakir

et al. 2014

JNS

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F oreign body embolization is an unfortunate event that can complicate endovascular procedures. Intraluminal foreign bodies in the cerebral circulation are primarily described in the trauma, neurointerventional, and cardiac literature, although their true prevalence and incidence are unknown. There are no treatment guidelines for foreign body removal, and management depends on surgeon preference, previously described cases, and patient characteristics. We describe an unusual case of a guidewire introducer from a previous cardiac procedure that embolized within the right common carotid artery (CCA), causing the patient to experience a transient ischemic attack (TIA), and was surgically removed via a carotid cutdown approach. Case ReportHistory and Examination. A 64-year-old man presented to our facility with transient left-sided weakness and slurred speech consistent with a TIA several months after he had undergone complex mitral valve repair. The previous operation involved placement of a left-sided internal jugular venous catheter and a femoral artery cutdown for placement of an endovascular balloon in the aorta for cardiopulmonary bypass during the procedure. Postoperatively, the patient was treated with warfarin for 3 months. At the time of our examination, his National Institutes of Health Stroke Scale (NIHSS) score was 0, with no leftsided hemiparesis.Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair Department of Neurosurgery, Buffalo General Medical Center and Gates Vascular Institute at Kaleida Health, Buffalo, New YorkWith the use of endovascular techniques and indwelling catheters, potential complications can include embolization of fragments or components of various systems. The authors describe the surgical retrieval of a guidewire introducer from the right common carotid artery (CCA). A 64-year-old man was found to have a foreign body within the right CCA on CT angiography after he had presented with a transient ischemic attack. He had undergone a complex mitral valve repair several months before presenting to the authors' facility. That procedure involved a femoral artery cutdown and the insertion of an endovascular aortic balloon for cardiac bypass. As in most endovascular procedures, guidewire introducers were probably used to facilitate the introduction of the guidewire into the system during the procedure. Although rare, iatrogenic embolization of the introducer probably occurred during use of the guidewire. The guidewire introducer was successfully retrieved without complication by using a standard carotid cutdown approach. It is extraordinarily unusual for an extracorporeal part of an implantable system to embolize to the carotid circulation. To the authors' knowledge, this is the only reported case of an embolized guidewire introducer and the use of a carotid exposure to retrieve an intraluminal foreign body. This case demonstrates that a carotid cutdown approach can be used successfully for the retrieval of intraluminal extr...

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“…Although it has been reported that foreign bodies have remained in the body for up to seventeen years without major complications, the immediate removal of any embolized material is necessary due to the occurrence of well-known complications such as sepsis, endocarditis, myocardial perforation, arrhythmias and others 2,3 . Fisher and Ferreyro reported the incidence of death or serious complications in up to 71% of patients in whom the foreign body is not removed 4 . On the other hand, complications resulting from the removal of foreign bodies e133 are rare, and the success rate has been reported to reach up to 100% 5 .…”

Section: Discussionmentioning

confidence: 99%

Retirada percutânea de corpo estranho intracardíaco com técnica original

Martins

Faria

2007

Arq. Bras. Cardiol.

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We report on the case of a patient with a long term vascular catheter embolized into the right ventricle. This case had unique characteristics since both ends of the catheter were inaccessible for snare, which made it difficult to capture them using conventional techniques. We describe a new method to retrieve the foreign body through its mid-point portion, using a single catheter with two independent snare and hook systems.

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Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies

Cited by 289 publications

References 36 publications

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Totally Implantable Venous Access Devices in Children Requiring Long-Term Chemotherapy: Analysis of Outcome in 122 Children from a Single Institution.

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Retirada percutânea de corpo estranho intracardíaco com técnica original

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