Retained Catheter in the Aorta

Huang, Alex L.; Quesada, Daniel; Aguìñiga-Navarrete, Phillip; Rosbrugh, James W; Wan, Alexander

doi:10.5811/cpcem.2019.7.43425

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…The second delayed presentation was in a 25-year-old adult presenting with a complaint of intermittent epigastric and abdominal pulsation sensation that she had been experiencing for the prior year. 16 An USS showed no evidence of aneurysm or dissection but a 3.9-cm echogenic tubular structure was found in the distal abdominal aorta consistent with a retained catheter fragment. On further questioning, the patient was found to have a history of prematurity at 7 months at a peripheral hospital.…”

Section: Discussionmentioning

confidence: 88%

“…Breakage of the catheter can be due to a faulty or expired catheter, but more commonly, the catheter is transected if there is mal-positioning and the suture needs to be cut for it to be resited. 2 There have been 16 cases reported in the literature to date and most of these have been in very low birthweight (VLBW) premature babies. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] This is due to the increased need for invasive monitoring in these neonates, generally through access of the umbilical artery, as obtaining peripheral access can be difficult.…”

Section: Discussionmentioning

confidence: 99%

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Retrieval of a Broken Umbilical Artery Catheter in a Neonate

Doodnath

Landreth-Smith

Rampersad

2022

Journal of Neonatology

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Background Umbilical arterial catheterization is an extremely useful tool in the premature, sick neonate for intensive monitoring and as a source of arterial blood sampling. We describe the case of an inadvertent breakage of an umbilical artery catheter (UAC), to replace it, and the potential complications that can arise. Case Report A premature 33-week infant weighing 1.965 kg was admitted to the neonatal intensive care unit (NICU) and had umbilical catheterization. An abdominal X-ray (AXR) was done following the procedure to confirm the position, and the UAC was found to be too low, between T11 and T12. In attempting to replace it, the UAC was transected, with the umbilical stump bleeding, and the internal tip not seen. The patient underwent laparotomy and examination under anesthesia revealed a UAC that was palpable in the right lower quadrant and fluoroscopy revealed a tip in the external iliac artery. This migrated with each subsequent palpation. Meticulous dissection revealed a catheter which was palpable in the right internal iliac artery. The bifurcation was cleared, and vascular slings applied, getting proximal and distal control. The vessel was opened, and the catheter retrieved in its 15-cm entirety. The vessel was repaired with 7/0 Prolene suture. Conclusions This case is intended to highlight that even a trivial procedure of UAC removal must be done carefully with appropriate instrumentation to prevent this complication. For retrieval of this type of vascular foreign body, an open technique can be used with the assistance of fluoroscopy. Endovascular retrieval techniques are also an option but are not available in our setting for this age group.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Retrieval of a Broken Umbilical Artery Catheter in a Neonate

Doodnath

Landreth-Smith

Rampersad

2022

Journal of Neonatology

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“…A successful conservative approach of leaving the UAC fragment in situ has not been described in any of the above cases. There is only one case of long-term UAC in situ of a 25-year-old woman who was found to have 3.9 cm of retained UAC in her aorta after presenting with intermittent epigastric and abdominal pulsations, that suffered no other complications 14…”

Section: Discussionmentioning

confidence: 99%

Infraumbilical surgical retrieval of transected umbilical artery catheter in an 840 g newborn

et al. 2022

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An 840 g female baby born at 25 weeks gestation suffered a rare complication of umbilical arterial catheter (UAC) insertion, involving an accidental transection resulting in 11 cm of retained catheter inside the baby. Investigations revealed migration of the proximal tip of the catheter within 10 hours into the left subclavian artery.This complication is rare and has not frequently been described in the literature. Given the size and gestation of the patient, the risks and benefits of both conservative and non-conservative management were discussed in detail prior to any treatment decision being made. Effective multidisciplinary teamwork contributed to the successful removal of the UAC, done via a minimally invasive infraumbilical approach, associated with no further complications.

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“…This usually occurs during removal or repositioning of the catheter, especially when cutting the attached suture, but has also been reported during catheter insertion [ 14 ]. A literature re view discovered only 15 cases reported since 1972 [ 2 , 5 – 17 ]. As in our patient, most fractured UACs were found in VLBW premature neonates.…”

Section: Discussionmentioning

confidence: 99%

“…Infrequently, these catheters can fracture or break resulting in retained fragments, leading to thrombosis, distal embolization, and ischemia [ 3 , 4 ]. Over the past 50 years, only 15 cases of bro ken UACs have been reported in the literature [ 2 , 5 – 17 ], with bilateral lower extremity ischemia presented in only one prior case. Here we de scribe the removal of a retained UAC fragment in a very low birth weight (VLBW) neonate, including post-discharge follow-up for three years.…”

Section: Introductionmentioning

confidence: 99%

Bilateral lower extremity ischemia due to a retained umbilical artery catheter in a preterm neonate

Birkhold

Khalifeh

Strauch

2020

Journal of Pediatric Surgery Case Reports

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The use of umbilical artery catheters is common in Neonatal Intensive Care Units, especially in low and very low birth weight neonates. Rarely, these can break or fracture, leading to a retained fragment, which can embolize or cause thrombosis. We pre sent a case of a very low birth weight, premature neonate, 940 grams, with a retained umbilical artery catheter that led to bilateral lower extremity ischemia. A laparotomy with aortotomy was per formed for retrieval of the catheter. Chronic occlusion of the aorta with collateralization is a long-term complication associated with this case.

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Retained Catheter in the Aorta

Cited by 4 publications

References 5 publications

Retrieval of a Broken Umbilical Artery Catheter in a Neonate

Retrieval of a Broken Umbilical Artery Catheter in a Neonate

Infraumbilical surgical retrieval of transected umbilical artery catheter in an 840 g newborn

Bilateral lower extremity ischemia due to a retained umbilical artery catheter in a preterm neonate

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