75 IMAGING IN CARDIOLOGYLasso technique for retrieving a broken, dislocated port-a-cath fragment A 52-year-old woman suffering from breast cancer had a port-a-cath implanted to administer chemotherapy. A port-a-cath (a portmanteau of portal and catheter) consists of a reservoir compartment (the portal) which has a silicone bubble for needle insertion (the septum) mounted to the catheter. Six and a half months after implantation, she complained of palpitations. An ECG showed sinus rhythm with premature atrial complexes. An X-ray showed dislocation of the distal tip of the catheter with migration into the right atrium (RA) and right ventricle (RV).To remove the port-a-cath fragment, we performed a right heart catheterisation by inserting an 8 French sheath into the femoral vein. Using the lasso technique, a long standard guide wire (0.018 inch, 260 cm) was advanced through the lumen of the 7 F intervention catheter (MPA-1, Cordis, Vista bright tip, 100 cm, .078 ID), as shown in figure 1. By manipulating and applying traction to both ends of the guide wire and the catheter, we were able to adjust the diameter and direction of the loop to capture and secure the broken, dislocated port-a-cath fragment. This was then drawn up to the tip of the intervention catheter (figure 2) and successfully removed by extracting the intervention catheter outside the sheath. By both collapsing and banding the broken port-a-cath fragment at its midpoint, the sharp barbs at the end of this were directed away from the vein wall, thus minimising injury during
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.