Type:
Educational Exhibit
Keywords:
Angioplasty, Catheter arteriography, Fluoroscopy, Foreign bodies, Outcomes, Angioscopy, Vascular, Interventional vascular
Authors:
A. Dablan, O. Ozgur; Antalya/TR
DOI:
10.1594/ecr2018/C-2228
Conclusion
Port catheter dislodgement is seen in 0-4.1% of cases,
with up to 71% of them facing death or serious complications.
Dislodged catheter fragments can travel to the right heart or the pulmonary artery and might cause arrhythmias or pulmonary thromboembolism,
potentially threatening life.
Therefore,
the dislodged catheter should be removed as soon as possible,
which might be achieved with percutaneous retrieval,
open thoracotomy retrieval,
and long-term anticoagulant therapy. The common location of a dislodged catheter was the right atrium to the inferior vena cava (IVC),
the superior vena cava (SVC) and pulmonary artery. The current management techniques of a dislodged central venous port catheter include percutaneous retrieval,
open thoracotomy retrieval,
and long-term anticoagulant therapy.
If there is an accessible free end for retrieval of the dislodged catheter,
several devices are available for use,
including the loop snare,
basket,
and the balloon catheter.
However,
if no accessible free end for retrieval is available,
a pigtail catheter may be used to relocate the dislodged port catheter followed by loop snare retrieval.
The most common procedure-related complications are local hematoma over the puncture site or cardiac arrhythmias.
Using pigtail and loop snare catheters concurrently is a highly efficient,
atraumatic,
safe and easy method to retrieve dislodged port catheter fragments.