Retrieval of embolised fractured PICC
Peripherally inserted central catheters are commonly used for intravascular access in low birth weight neonates. Here, we describe a case of transcatheter retrieval of an embolised peripherally inserted central catheter line in the right ventricle extending to the left pulmonary artery in a preterm very low birth weight baby. To the best of our knowledge, this is the first case where transcatheter retrieval of embolised peripherally inserted central catheter line has been done from the left pulmonary artery in such a very low birth weight preterm neonate. Although retrieval of foreign body is common in adults and older children, very few case reports have documented successful retrieval of embolised peripherally inserted central catheter line in very low birth weight neonates using interventional techniques. Most of the cases in literature reported retrieval of an indwelling umbilical venous catheter rather than a peripherally inserted central catheter line as in our case. Also, none of these cases had the embolised fragment retrieved from the left pulmonary artery. This approach was technically very challenging as we were taking care of a 5-day old preterm neonate born at 32 weeks of gestation having very low birth weight (1100 g) with features of clinical sepsis, coagulopathy, and embolised catheter fragment extending from right ventricle to left pulmonary artery. The procedure was uneventful without any complication and the catheter was retrieved successfully.
Bishnoi S, Banerji N, Champaneri B, Deodhar S. Transcatheter retrieval of embolised fractured peripherally inserted central catheter: a nightmare in very low birth weight preterm neonate. Cardiol Young. 2022 Sep 1:1-4. doi: 10.1017/S1047951122002761. Epub ahead of print. PMID: 36047467.