Abstract:
We report a novel two-step percutaneous endovascular technique for retrieval of peripherally inserted central catheter, free ends of which were inaccessible, that had embolized to the segmental branch of left pulmonary artery using SIM 1 catheter and a loop snare, in a 17 year old female patient diagnosed with osteosarcoma right femur. Step one involved, inserting SIM 1 catheter through the heart to hook the embolized peripherally inserted central catheter and bring it down to the lower segment of inferior vena cava. In the second step, a loop snare was used to grasp the free end of peripherally inserted central catheter, and the whole assembly was withdrawn via right common femoral vein access. Patient was monitored for 24 hours and discharged as there were no complications. SIM 1 catheter followed by the use of loop snare as a retrieval system is safe and efficacious and can be considered by an intervention radiologist for retrieval of embolized vascular access device, in which none of the free ends are available to catch hold with a loop snare.
Reference:Sood S, Srinivasan S. Retrieving embolized peripherally inserted central catheter – A novel two step technique. Radiol Case Rep. 2021 Dec 16;17(3):531-536. doi: 10.1016/j.radcr.2021.11.044. PMID: 34976259; PMCID: PMC8688964.