A Novel Two-Step Technique for Retrieving Fractured Peripherally Inserted Central Catheter Segments Migrating into the Heart or the Pulmonary Artery

Abstract

Objective. To report the experience of a percutaneous technique for retrieving fractured peripherally inserted central catheter (PICC) segments migrating into the heart or the pulmonary artery. Method. From April 2013 to July 2015, we performed percutaneous retrieval of fractured PICC segments migrating into the heart or the pulmonary artery in five cancer patients who had undergone chemotherapy via PICC. The fractures were diagnosed with chest plain radiography. The patients included three cases of breast cancer, one case of rectal cancer, and one case of lower limb Ewing's tumor. The fractures were retained in the vessels of the patients for 1 to 3 days. All the fractures were retrieved by using a novel two-step technique in the digital subtraction angiography (DSA) suite. This two-step technique involves inserting a pigtail catheter to the heart or the pulmonary artery to grasp the fractured catheter fragment and bring it to the lower segment of the inferior vena cava, followed by grasping and removing the catheter fragment with a retrieval loop system of the vena cava filter retrieval set. Result. The fractured PICC segments were removed successfully in all five patients via unilateral (four patients) or bilateral (one patient) femoral vein access. No complications occurred during the interventional procedure. Conclusion. Percutaneous retrieval can be a safe, convenient, and minimally invasive method for the removal of fractured PICC segments. The technique reported in this paper will be applicable for the retrieval of fractured PICC segments and other catheter fragments migrating into the heart or the pulmonary artery.

Successful percutaneous transvenous retrieval of intravascular fractured port catheter: a single center experience

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The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit

“…Compared with the traditional CVCs technique, PICC exerts various advantages, such as convenient placement without pleura-pulmonary damage, low cost, and long-term and stable vein access 3 , 4 . At present time, PICC has become widespread in clinical management for extended courses of chemotherapy, medication administration, and parenteral nutrition 5 , especially with the introduce of Power-injected PICC. Power PICC is made of ultra-resistant polyurethane which allows high flow injection using high pressure pump.…”

Endovascular extraction of a disconnected port-A catheter from inferior vena cava in a patient with chronic bilateral occlusion of femoroiliac veins: A case report

“…Although the catheter placement is relatively safe, several potential complications can occur including catheter dislodgement, catheter malposition, catheter compression and catheter fracture (2). The dislodged catheter scan migrates along the blood stream to the superior vena cava, the right atrium, the right ventricle, the main pulmonary artery or its branches (3,4). The risk factors for intravascular thrombus formation in case of catheter migration include endothelial injury, hemodynamic flow changes within vessel and partial stasis (5,6).…”

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