ASDIN Clinical Case Focus: Retrieval of a Fractured Piece of Tessio Catheter with a Snare Using a Transcutaneous Transvenous Approach

Abstract

Approximately 20% of end-stage renal disease patients requiring hemodialysis have central dialysis catheters as their vascular access. The major cause of central dialysis catheters removal or revision is infection or occlusion. Catheter occlusions may occur as a result of thrombosis or fibrin sheath formation. However, the presence of a fractured dialysis catheter tip requiring immediate extraction to prevent serious complications is rare. Herein we present the case of a central dialysis catheter referred to us for malfunction. An incidental finding was a piece of catheter that had broken off the venous port and was seen in the right atrium. The retrieval and subsequent placement of a new central dialysis catheter are outlined.

The clinical application of the dental mini C-arm for the removal of broken instruments in soft and hard tissue in the oral and maxillofacial area

“…Inappropriate use of metal instruments, such as needles, probes, scalpel blades, and catheters (Bump and Roche, 1973;Bedrock et al, 1999;Prasad et al, 2000;Miura et al, 2001;Oztekin, 2005;Zaman et al, 2005;Ma et al, 2006), can result in their breakage during surgery. These are then capable of moving to an unexpected site in soft tissue or interfering with further treatment procedures, like tooth extractions and implant placement.…”

“…An intrapulmonary aberrant needle was removed under fluoroscopic guidance to avoid re-thoracotomy (Miura et al, 2001), and symptomatic bone anchors placed during stress incontinence surgery were successfully removed, along with surrounding bone, with fluoroscopy (Stoffel et al, 2005). Zaman et al (2005) reported retrieval of broken dialysis catheters under fluoroscopic guidance.…”

Successful Retrieval of an Irretrievable Jugular Tesio Catheter Using a Fogarty Arterial Embolectomy Catheter

“…Some cases have been reported in recent literature showing the difficulties encountered in the retrieval of catheters that were used for long term and a fibrin sheath wraps the catheter along its trajectory. [4][5][6][7]…”

Wandering Catheter Through Pulmonary Vasculature

“…Migration of portions of central catheters has been described in the past, with retrieval from the cavae[ 8 ], right atrium[ 9 ], right ventricle[ 10 ], and pulmonary arteries[ 11 ]. Although many patients, such as this one, have remained asymptomatic[ 12 ], migration of catheters has been associated with serious complications such as pulmonary embolism with subsequent pulmonary infarction[ 13 ], myocardial or pulmonary parenchymal perforation[ 14 ] and palpitations and arrhythmias[ 15 ].…”