“Pigtail through snare” technique: an easy and fast way to retrieve a catheter fragment with inaccessible ends

Abstract

Background A catheter fragment with inaccessible ends can be retrieved using the well-known two-step method: making a free end with a pigtail catheter and seizing it with a snare catheter. Here we propose an easier and faster modification, named the “pigtail through snare” technique. Case presentation A 61-year-old female patient underwent removal of a central venous catheter fragment migrating to the right atrium. Both ends located in the right atrial appendage and left hepatic vein were inaccessible. Initially, a snare loop was opened in the inferior vena cava and a pigtail catheter was advanced through the snare loop to hook the catheter fragment. The free end was created by pulling the pigtail catheter, dragged automatically into the snare loop, grasped, and retrieved immediately. Conclusions By passing the pigtail catheter through the snare loop in advance, the snaring maneuver becomes easy and fast in retrieving the catheter fragment with inaccessible ends.

Retrieval of a dislodged porth catheter with inaccessible tips in a pediatric cancer patient

“…The fluoroscopy time (57 min), air kerma was kept relatively low (734 mGy) using collimators. Compared to radiation doses above study (Kalińczuk et al 2016), it is relatively low yet still higher than the authors' patient skin dose of 68.12 mGy (Mori et al 2021) due to longer procedure time.…”

“…To the Editor, We read the article entitled "Pigtail through snare technique: an easy and fast way to retrieve a catheter fragment with inaccessible ends" with great interest. Here, a modified technique, hooking the catheter fragment with a pigtail catheter advanced through the snare loop, is described by the authors to retrieve the catheter fragment with inaccessible ends in a prompt fashion (Mori et al 2021). Dislodged venous catheter fragments are retrieved successfully by interventional radiologists for decades using mainly two methods: loop snare or grasping forceps.…”

Percutaneous Retrieval of Dislodged Chemo Port Catheter With Inaccessible Tips by a Simplified Technique

“…Haga and Shindo have described a modified loop snare technique wherein, similar to the present case, a wire was looped around the dislodged catheter to reposition it into the IVC and then directly snared out [ 8 ]. Another strategy to retrieve catheters with inaccessible ends is the use of pigtail catheters [ 6 , 9 ]. The uniqueness of the present case lies in the fact that the catheter loop was rather shallow and deeply placed in the RV.…”

Long loop technique with bifemoral access as salvage technique for repositioning of dislodged port catheters

“…A recent study used a similar maneuver to remove a fragment of a central venous catheter which migrated in the right atrium, with both ends in the atrial appendage and thus not easily accessible for the goose snare (Mori et al 2021). Similarly, other recent studies created a long loop to mobilize a free end of a fractured port catheter into the inferior cava vein, which was located across the right atrium and ventricle and consequently di cult to be caught with a snare (Haga et al 2020;Shah et al 2022).…”

“…Nevertheless, in rare cases, in which the catheter is embedded in a (at least partially) thrombotic occluded vein branch (e.g. azygos vein), there is no free end to be caught with the goose snare and the pigtail catheter may not be stable enough to retrieve the catheter (Mori et al 2021). Here we present a technique in which a long loop across the dislodged catheter was established with a goose snare and the guidewire after venous access via both femoral veins in order to increase the stability and reposition the port catheter.…”