Percutaneous retrieval of fractured PICC fragments via the femoral vein

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“Via femoral vein access, PICC fractures could be removed with common interventional instruments such as a goose snare, basket catheter and pigtail catheter. The interventional retrieval is a safe, convenient and minimally invasive method for the removal of PICC fractures.” Wang et al (2014).

Reference:

Wang, Q., Xiong, B., Zheng, C., Feng, G., Liang, M. and Liang, H. (2014) Percutaneous retrieval of PICC fractures via the femoral vein in six cancer patients. The Journal of Vascular Access. September 1st. [epub ahead of print].

Abstract:

PURPOSE: To investigate the feasibility and safety of the interventional technique of retrieving the fractured peripherally inserted central catheter (PICC) segments within the vessels via the femoral vein.

METHODS: From July 2007 to January 2012, we performed percutaneous retrieval of PICC fractures in six cancer patients who accepted chemotherapy via PICC. The fractures occurred during the traction of the catheter and were diagnosed with chest plain film radiography and/or computed tomography. The patients included four cases of ovarian cancer, one case of breast cancer and one case of cervical cancer. The fractures were retained in the vessels of the patients for 1 to 10 days. According to the location of the ends of the PICC fractures, three methods were employed using the most commonly used interventional devices in the digital subtraction angiography suite.

RESULTS: The PICC fractures were located in the subclavian vein, superior vena cava, right atrium, right ventricle or pulmonary arteries. During the procedures, a goose neck snare, pigtail catheter and stone basket catheter were used individually or in combination. The PICC fractures were removed successfully in all six patients via unilateral or bilateral femoral vein access. No major complications occurred during the operation or the follow-up period of 7 to 10 days.

CONCLUSIONS: Via femoral vein access, PICC fractures could be removed with common interventional instruments such as a goose snare, basket catheter and pigtail catheter. The interventional retrieval is a safe, convenient and minimally invasive method for the removal of PICC fractures.

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