Expandable intravascular catheter: percutaneous use for endoluminal retrievals.

Objective: Retained surgical drains can lead to significant complications including gastrointestinal fistulae, abscess formation and intestinal obstruction. Today, there is little in the literature describing the role of Interventional Radiology (IR) in assisting the removal of surgical drains. We describe the use of the well-established intraluminal catheter plasty technique, previously used for the removal of adhered central venous catheters, in order to remove a tethered abdominal drain. Methods and materials: A 67-year-old female was referred to the IR department for the removal of a 24 Fr Robinson’s intra abdominal surgical drain that could not be removed by conventional methods, as there was a concern that it was kinked internally. Both fluoroscopy and cone beam CT was performed which identified the drain to be sited within the pelvis with no kinks. A first attempt to remove the drain over a 0.035 stiff wire was unsuccessful due to resistance and patient discomfort. We suspected that this was due to adhesions surrounding the drain. Consequently, a 9 x 40mm angioplasty balloon was used over the wire with serial dilatations along the drain to disrupt the adhesions. Several areas of waisting were identified. The drain was gently withdrawn over the wire with minimal resistance. Ex-vivo inspection of the drain showed no evidence of structural damage and fluoroscopic imaging confirmed no retained fragments. Conclusion: We describe a safe and effective novel technique of intraluminal catheter plasty used to remove a tethered surgical drain following failed conventional methods.

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“…4 Balloon angioplasty has also been used to assist in intravascular foreign body removal and manipulate intravascular stents. 5 …”

Section: Discussionmentioning

confidence: 99%

Intraluminal catheter plasty. An alternative technique to remove tethered abdominal surgical drains

et al. 2021

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“…Mismatch between the size of the introducer device and the vessel lumen, however, was a primary limitation. Recently, a variable-diameter sheath has been devised to overcome this problem [5,6]; however, this was made only for intraoperative insertion and no systematic evaluation has been performed. Vorwerk et al [7,8] suggested a tulip sheath that could be inserted percutaneously and consisted of a costly self-expandable stent (Wallstent, Schneider Europe, Zurich, Switzerland).…”

Section: Discussionmentioning

confidence: 99%