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Percutaneous retrieval of intravascular venous foreign bodies in children

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Abstract

Background

The use of vascular lines both venous and arterial in children has significantly increased in the last decade with the potential risk that an intravascular device may become an intravascular foreign body. Percutaneous retrieval by interventional radiology has become an accepted method of foreign body removal.

Objective

The objective of this study is to describe a single center’s experience of percutaneous intravascular foreign body removal in pediatric patients.

Materials and methods

Between January 2000 and December 2008, 18 patients underwent percutaneous intravascular foreign body retrieval as a complication of venous access devices. The mean catheter days were 181.2 catheter days (1 to 1,146 days). A retrospective review was performed and demographic data and clinical information were recorded, including type, duration, location of access device, embolization location and retrieval technique.

Results

Eighteen of 19 (94.7%) retrievals were performed with single-loop snares and 1/19 (5.3%) was a triple-loop snare. Seventeen of 19 (89.5%) retrievals were successful. One unsuccessful retrieval was successfully removed by surgery, while the other was retained.

Conclusion

Percutaneous intravascular foreign body retrieval by interventional radiologists is a safe and effective method of retrieving embolized fragments from venous access devices in pediatric patients.

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References

  1. Fadrowski JJ, Hwang W, Neu AM et al (2009) Patterns of use of vascular catheters for hemodialysis in children in the United States. Am J Kidney Dis 53:91–98

    Article  PubMed  Google Scholar 

  2. Carausu L, Clapisson G, Philip I et al (2007) Use of totally implantable catheters for peripheral blood stem cell apheresis. Bone Marrow Transplant 40:417–422

    Article  PubMed  CAS  Google Scholar 

  3. Matsuzaki A, Suminoe A, Koga Y et al (2006) Long-term use of peripherally inserted central venous catheters for cancer chemotherapy in children. Support Care Cancer 14:153–160

    Article  PubMed  Google Scholar 

  4. Puntis JW (1986) Percutaneous insertion of central venous feeding catheters. Arch Dis Child 61:1138–1140

    Article  PubMed  CAS  Google Scholar 

  5. Yeung CY, Lee HC, Huang FY et al (1998) Sepsis during total parenteral nutrition: exploration of risk factors and determination of the effectiveness of peripherally inserted central venous catheters. Pediatr Infect Dis J 17:135–142

    Article  PubMed  CAS  Google Scholar 

  6. Bodner LJ, Nosher JL, Patel KM et al (2000) Peripheral venous access ports: outcomes analysis in 109 patients. Cardiovasc Intervent Radiol 23:187–193

    Article  PubMed  CAS  Google Scholar 

  7. Chait PG, Ingram J, Phillips-Gordon C et al (1995) Peripherally inserted central catheters in children. Radiology 197:775–778

    PubMed  CAS  Google Scholar 

  8. Fazeny-Dorner B, Wenzel C, Berzlanovich A et al (2003) Central venous catheter pinch-off and fracture: recognition, prevention and management. Bone Marrow Transplant 31:927–930

    Article  PubMed  CAS  Google Scholar 

  9. Morello FP, Donaldson JS, Saker MC et al (1999) Air embolism during tunneled central catheter placement performed without general anesthesia in children: a potentially serious complication. J Vasc Interv Radiol 10:781–784

    Article  PubMed  CAS  Google Scholar 

  10. Lin CH, Wu HS, Chan DC et al (2010) The mechanisms of failure of totally implantable central venous access system: analysis of 73 cases with fracture of catheter. Eur J Surg Oncol 36:100–103

    Article  PubMed  CAS  Google Scholar 

  11. Chow LM, Friedman JN, Macarthur C et al (2003) Peripherally inserted central catheter (PICC) fracture and embolization in the pediatric population. J Pediatr 142:141–144

    Article  PubMed  Google Scholar 

  12. Surov A, Wienke A, Carter JM et al (2009) Intravascular embolization of venous catheter–causes, clinical signs, and management: a systematic review. JPEN J Parenter Enteral Nutr 33:677–685

    Article  PubMed  Google Scholar 

  13. Surov A, Jordan K, Buerke M et al (2006) Atypical pulmonary embolism of port catheter fragments in oncology patients. Support Care Cancer 14:479–483

    Article  PubMed  Google Scholar 

  14. Pittiruti M, Cina A, Cotroneo A et al (2000) Percutaneous intravascular retrieval of embolised fragments of long-term central venous catheters. J Vasc Access 1:23–27

    PubMed  CAS  Google Scholar 

  15. Mirza B, Vanek VW, Kupensky DT (2004) Pinch-off syndrome: case report and collective review of the literature. Am Surg 70:635–644

    PubMed  Google Scholar 

  16. Dondelinger RF, Lepoutre B, Kurdziel JC (1991) Percutaneous vascular foreign body retrieval: experience of an 11-year period. Eur J Radiol 12:4–10

    Article  PubMed  CAS  Google Scholar 

  17. Liu JC, Tseng HS, Chen CY et al (2002) Percutaneous retrieval of intravascular foreign bodies: experience with 19 cases. Kaohsiung J Med Sci 18:492–499

    PubMed  Google Scholar 

  18. Wolf F, Schernthaner RE, Dirisamer A et al (2008) Endovascular management of lost or misplaced intravascular objects: experiences of 12 years. Cardiovasc Intervent Radiol 31:563–568

    Article  PubMed  Google Scholar 

  19. Aitken DR, Minton JP (1984) The ‘pinch-off sign’: a warning of impending problems with permanent subclavian catheters. Am J Surg 148:633–636

    Article  PubMed  CAS  Google Scholar 

  20. Hinke DH, Zandt-Stastny DA, Goodman LR et al (1990) Pinch-off syndrome: a complication of implantable subclavian venous access devices. Radiology 177:353–356

    PubMed  CAS  Google Scholar 

  21. Sarzo G, Finco C, Zustovich F et al (2004) Early rupture of subclavian vein catheter: a case report and literature review. J Vasc Access 5:39–46

    PubMed  CAS  Google Scholar 

  22. Nostdahl T, Waagsbo NA (1998) Costoclavicular pinching: a complication of long-term central venous catheters. A report of three cases. Acta Anaesthesiol Scand 42:872–875

    Article  PubMed  CAS  Google Scholar 

  23. Denny DF Jr (1993) Placement and management of long-term central venous access catheters and ports. AJR 161:385–393

    PubMed  Google Scholar 

  24. Ong CK, Venkatesh SK, Lau GB et al (2010) Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters. J Vasc Interv Radiol 21:1191–1196

    Article  PubMed  Google Scholar 

  25. Fisher RG, Ferreyro R (1978) Evaluation of current techniques for nonsurgical removal of intravascular iatrogenic foreign bodies. AJR 130:541–548

    PubMed  CAS  Google Scholar 

  26. Liu JC, Tseng HS, Chen CY et al (2004) Percutaneous retrieval of 20 centrally dislodged Port-A catheter fragments. Clin Imaging 28:223–229

    Article  PubMed  Google Scholar 

  27. Leal Filho JM, Carnevale FC, Nasser F et al (2010) Endovascular techniques and procedures, methods for removal of intravascular foreign bodies. Rev Bras Cir Cardiovasc 25:202–208

    Article  Google Scholar 

  28. Savage C, Ozkan OS, Walser EM et al (2003) Percutaneous retrieval of chronic intravascular foreign bodies. Cardiovasc Intervent Radiol 26:440–442

    Article  PubMed  Google Scholar 

  29. Gabelmann A, Kramer S, Gorich J (2001) Percutaneous retrieval of lost or misplaced intravascular objects. AJR 176:1509–1513

    PubMed  CAS  Google Scholar 

  30. Koseoglu K, Parildar M, Oran I et al (2004) Retrieval of intravascular foreign bodies with goose neck snare. Eur J Radiol 49:281–285

    Article  PubMed  Google Scholar 

  31. Gerlock AJ Jr, Mirfakhraee M (1987) Retrieval of intravascular foreign bodies. J Thorac Imaging 2:52–60

    Article  PubMed  Google Scholar 

  32. Paulus BM, Fischell TA (2010) Retrieval devices and techniques for the extraction of intravascular foreign bodies in the coronary arteries. J Interv Cardiol 23:271–276

    Article  PubMed  Google Scholar 

  33. Bonvini RF, Rastan A, Sixt S et al (2009) Percutaneous retrieval of intravascular and intracardiac foreign bodies with a dedicated three-dimensional snare: a 3-year single center experience. Catheter Cardiovasc Interv 74:939–945

    Article  PubMed  Google Scholar 

  34. Andrews RE, Tulloh RM, Rigby ML (2002) Percutaneous retrieval of central venous catheter fragments. Arch Dis Child 87:149–150

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology Perelman School of Medicine, Children’s Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA, 19104, USA

    Anne Marie Cahill & Deddeh Ballah

  2. Bogota, Columbia

    Paula Hernandez & Lucia Fontalvo

Authors
  1. Anne Marie Cahill
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  2. Deddeh Ballah
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  3. Paula Hernandez
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  4. Lucia Fontalvo
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Correspondence to Anne Marie Cahill.

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Cahill, A.M., Ballah, D., Hernandez, P. et al. Percutaneous retrieval of intravascular venous foreign bodies in children. Pediatr Radiol 42, 24–31 (2012). https://doi.org/10.1007/s00247-011-2150-z

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  • DOI: https://doi.org/10.1007/s00247-011-2150-z

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