Inline balloon-assisted vascular sheath fragment removal

CVIR Endovascular - Tập 3 - Trang 1-5 - 2020
Neema Jamshidi1, Jason Chiang1
1Department of Radiological Sciences, UCLA, Los Angeles, USA

Tóm tắt

Unretrievable foreign bodies are associated with high morbidity and mortality. While the majority of reported cases involve the venous circulation, intra-arterial foreign body displacement have the potential to migrate more distally with a higher risk for dissection and hemorrhagic complications during retrieval. As the number of intravascular procedures continues to increase, there is also likely to be a concomittant increase in the number of retrieval procedures, particular for fractured catheters and sheaths. Although snaring is frequently the traditional, ‘go-to’ method for retrieval, there are inherent risks of further dislodgement or fracture. We describe a case that involves retrieval of a fractured sheath that originated in the common femoral artery but migrated into the popliteal artery. Different retrieval approaches were employed, however ultimately balloon assisted, over-the-wire retrieval was the successful approach. We anticipate that over-the-wire, inline-retrieval approaches will continue to grow in popularity and use, particularly with respect to manipulation within the arterial circulation.

Tài liệu tham khảo

Carroll MI, Ahanchi SS, Kim JH, Panneton JM (2013) Endovascular foreign body retrieval. J Vasc Surg 57(2):459–463 Egglin TK, Dickey KW, Rosenblatt M, Pollak JS (1995) Retrieval of intravascular foreign bodies: experience in 32 cases. AJR Am J Roentgenol 164(5):1259–1264 Fisher RG, Ferreyro R (1978) Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. AJR Am J Roentgenol 130(3):541–548 Gupta AK, Purkayastha S, Krishnamoorthy T (2005) Percutaneous retrieval of intravascular broken catheter fragments. A novel technique using a balloon. Interv Neuroradiol 11(2):149–154 Hehir DJ, Cross KS, Kirkham R, Moore DJ, Shanik DG (1992) Foreign body complications of central venous catheterisation in critically ill patients. Ir J Med Sci 161(2):49–51 Karaca O, Cakal B, Omaygenc O, Turkmen M (2016) Percutaneous retrieval of an embolized catheter tip with the balloon dilatation technique. Res Cardiovasc Med 5(1):e30890 [cited 2020 Jan 5] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752695/ Koseoglu K, Parildar M, Oran I, Memis A (2004) Retrieval of intravascular foreign bodies with goose neck snare. Eur J Radiol 49(3):281–285 Mehta V, Pandit BN, Yusuf J, Mukhopadhyay S, Trehan V, Tyagi S (2014) Retrieval of impacted broken balloon by balloon inflation in guiding catheter. Cardiovasc Interv Ther 29(3):252–255 Ramachandran P, Reddy RP, Rao MS, Jayaram AA (2016) A novel approach for the retrieval of broken catheter fragment - using balloon dilatation technique. J Clin Diagn Res 10(3):OD10–OD11 Rossi P (1970) “Hook catheter,” technique for transfemoral removal of foreign body from right side of the heart. Am J Roentgenol Radium Therapy, Nucl Med 109(1):101–106 Tytle TL, Prati RC, McCormack ST (1995) The “gooseneck” concept in microvascular retrieval. AJNR Am J Neuroradiol 16(7):1469–1471