Percutaneous retrieval of intravascular foreign body in children: a case series and review

Abstract

Background Percutaneous retrieval of intravascular foreign bodies has recently increased as a treatment option. Purpose To report our single-center experience of the percutaneous retrieval of 14 intravascular embolized catheter fragments in children and to conduct a literature review. Material and Methods MEDLINE databases were searched for case reports and series including children and iatrogenic catheter fragments or guidewires retrieved through percutaneous techniques. We also conducted a retrospective analysis of 14 cases from our institution over a 14-year period. A total of 27 studies were selected comprising 74 children, plus our 14 unpublished cases. Statistical analyses were performed using Microsoft Excel version 2016. Results Port catheter fragments and peripherally inserted central catheters (PICCs) were the most embolized foreign bodies and the pulmonary artery was the most common site of embolization in 44.1% of cases. Analysis of the retrieval technique demonstrated a preference for extraction through the femoral vein (81.7%) and using snare techniques (93.5%). The success rate of percutaneous retrieval was 96.6% with only 1.1% of procedure-related complications. Patients were asymptomatic in 77.2% of cases, presented septic complications in 2.3%, and no deaths were reported. Median fluoroscopy time was 10 min (range = 1.7–80 min) and median procedure length was 60 min (range = 35–208 min). Conclusion Percutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children and should be considered the preferred treatment option.

Percutaneous snare-retrieval of intracardiac thrombus under fluoroscopic and transesophageal echocardiography guidance: case report and systematic review

“…There are also some reports of intracardiac needles and metal pieces due to drug use or trauma ( 47 ). In only 6 (5.1%) patients, percutaneous IFB removal was not successful ( 25 , 27 , 34 , 43 , 47 ). Snare catheters and forceps were the most commonly used instruments ( 25 , 27 , 46 ) Table 3 .…”

“…In only 6 (5.1%) patients, percutaneous IFB removal was not successful ( 25 , 27 , 34 , 43 , 47 ). Snare catheters and forceps were the most commonly used instruments ( 25 , 27 , 46 ) Table 3 .…”

Percutaneous Transcatheter Retrieval of Central Venous Port Fragments in Pediatric Patients; A Single-center Experience From the Pediatric Cardiology Department

“…To our knowledge, this study includes the largest number from a single center. Pediatric patients seem more prone to pediatric-specific complications, different devices are chosen in this group, and altered risks of thrombotic events could lead to more troublesome conditions compared with adults 7 . If a ruptured port catheter fragment which, for example, is trapped in the Superior vena cava (SVC), being completely endothelialized without any lumen obstruction, it must be removed at all or shall it be better left in situ, is unanswered.…”

“…Although the incidence of embolic events, such as intravascular foreign bodies (IVFB), related to catheters in children has not been clearly identified, the rate of catheter embolization was found to be 0.67% in one study 4 . Because of the rare, fatal complications (myocardial perforation, tamponade, arrhythmia, infective endocarditis, etc) that can be seen with the embolization of IVFB to the heart and pulmonary arteries, it is preferable to extract the foreign material 5–7 …”

“…4 Because of the rare, fatal complications (myocardial perforation, tamponade, arrhythmia, infective endocarditis, etc) that can be seen with the embolization of IVFB to the heart and pulmonary arteries, it is preferable to extract the foreign material. [5][6][7] Of the reported cases in the literature, all were asymptomatic after extraction. [8][9][10][11][12] Historically, in the 1950s, surgical treatment was seen as the first choice in the initial cases.…”