Percutaneous transvenous retrieval of CVP catheter emboli in S.V.C.: A case report

The increasing use of the in dwelling venous catheters and cardiovascular catheters has led to many iatrogenic complications. One of the most serious complications is catheter embolization, caused by inadvertent fracture of afragment of catheter remaining within cardiovascular systems. In the catheter embolization, there are serious consequence such as thromboembolism, sepsis, cardiac arrythmia and others. Fisher and Ferreyro(1978) reported a71% incidence of serious morbidity of death following to intravascular foreign bodies in patients without removal. The authors experinced a case of retained central venous pressure monitoring catheter(CVP catheter) fragment extending from superior vena cava to hepatic segment of inferior vena cava. CVP catheter was introduced into right subclavian venous route for hyper alimentation, because of poor general condition for operation of afferent loopsyndrome following to resection of the gastric carcinoma with Billoth II operation(5 years ago). On attempting to removal of CVP catheter on recovery from afferent loop syndrome, a large portion of the CVP catheter was cut offinto S.V.C. Percutaneous puncture of right femoral vein with Seldinger technique was done and 9F introducer sheathwas indwelled. The hellical basket of Dotter intravascular retriever set was advanced through the sheath uptoretained CVP catheter, and it was grapsed. The retrieved CVP catheter fragment showed several tiny blood clots onsurface. The patient was uneventfuly recovered. and was discharged asymptomatic on second day of the procedure.