Endovascular techniques and procedures, methods for removal of intravascular foreign bodies

Rev Bras Cir Cardiovasc. 2010 Apr-Jun;25(2):202-8. doi: 10.1590/s0102-76382010000200012.
[Article in English, Portuguese]

Abstract

Introduction: The incidence of intravascular embolization of venous catheters reported in the world medical literature corresponds to 1% of all the described complications. However, its mortality rate may vary between 24 to 60%. Catheter malfunction is the most likely signal of embolization, since patients are usually asymptomatic.

Objective: To report the method of removing intravascular foreign bodies, catheters with the use of various endovascular techniques and procedures.

Methods: This is a two-year retrospective study of 12 patients: seven women and five men. The average age was 29 years (ranging from two months to 65 years).

Results: Technical performance was 100% successful. Ten port-a-caths, one intra-cath and one PICC were extracted. The most common sites for the lodging of one of the ends of the intravascular foreign bodies were the right atrium (41.6%) and the right ventricle (33.3%). In 100% of the cases, only one venous access was used for extraction of foreign bodies, and in 91.6% of the cases (11 catheters) the femoral access was used. The loop-snare was used in 10 cases (83.3%). The most common cause of intravascular foreign body insertion was a catheter fracture, which occurred in 66.6% of the cases (eight cases). One major complication, the atrial fibrillation, occurred (8.3%), which was related to the intravascular foreign body extraction. The mortality rate in 30 days was zero.

Conclusion: Percutaneous retrieval of intravascular foreign bodies is considered gold standard treatment because it is a minimally invasive, relatively simple, safe procedure, with low complication rates compared to conventional surgical treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiac Catheterization / instrumentation*
  • Catheters, Indwelling / adverse effects*
  • Child
  • Child, Preschool
  • Device Removal / methods*
  • Endovascular Procedures / methods*
  • Equipment Failure
  • Female
  • Femoral Vein / surgery
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / surgery*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult