Retrograde migration and endovascular retrieval of a venous bullet embolus

Abstract

Venous bullet embolism is a rare and complicated occurrence reported in approximately 0.3% of penetrating trauma. The management of bullet emboli is decided on a case-by-case basis, balancing the risk of the embolus itself against those associated with extraction. We report a case of a 19-year-old man who sustained a gunshot wound to the anterior chest, which migrated to the left internal iliac vein in a retrograde fashion. We were able to successfully retrieve the missile using an endovascular approach, thereby minimizing the morbidity associated with an open procedure.

An unusual case of foreign body pulmonary embolus: case report and review of penetrating trauma at a pediatric trauma center

“…Foreign body emboli include needles, bullets, and other projectile objects. The risk of a bullet lodging in the vascular system in penetrating trauma patients is *0.3 % [11]. Approximately, 80 % of foreign body or bullet emboli are arterial (systemic or pulmonary) [7] and the remaining emboli are venous [4].…”

“…Survival is contingent upon rapid diagnosis and treatment of major injuries [2]. Embolization of traumatic foreign bodies is even more uncommon [3][4][5][6][7][8][9][10][11][12][13]. Recently, we successfully treated a patient with penetrating cardiac trauma with embolization of a foreign body to the pulmonary circulation without major operative intervention.…”

An Elusive Bullet in the Gastrointestinal Tract: A Rare Case of Bullet Embolism in the Gastrointestinal Tract and a Review of Relevant Literature

“…The guns and ammunition used in a trauma are also important to identify, because bullet emboli are more common with smaller, blunt-nosed, short-length, or low-velocity bullets [1]. Patel et al [8] have concluded that the low incidence of bullet embolism is because two major prerequisites need to be satisfied for a projectile to become an embolus.…”

“…Bullet emboli are rare complications of gunshot injuries [1]. The relative rarity of the condition, along with potential lack of early symptoms, often leads to significant delay in diagnosis and treatment of the problem.…”

Asymptomatic Pellet Migration to the Heart: Report of a Case and Update on Proper Management

“…Therefore, the authors recommended surgical removal of the bullet. Moreover, the evolution of endovascular techniques has introduced a new, less invasive therapeutic method [12]. …”