Document Detail


Percutaneous intravascular retrieval of embolised fragments of long-term central venous catheters.
MedLine Citation:
PMID:  17638218     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Embolisation of a catheter fragment is a rare mechanical complication of long-term central venous access devices. From 1995 to 1999 we observed 10 cases: the cause of embolisation was the 'pinch-off syndrome' in half of the cases, and in 8 cases out of 10 the fragment had embolised in the pulmonary arterial vessels. Percutaneous transvenous retrieval was successful in all cases; it was performed mainly (8 cases out of ten) through the left transfemoral route, using a single-snare-loop device sometimes associated with a pig-tail catheter. We had no mortality and no major complications. On the basis of our experience, we believe that catheter embolisation of long-term central venous devices can be effectively prevented by adequate insertion technique, proper management of the device during its clinical use, and accurate removal technique. Nonetheless, should catheter em-bolisation occur, the patient should be referred to a Centre with adequate experience in the field of interventional radiological techniques. Should the radiological retrieval procedure fail, evidence from the literature suggests that leaving the fragment in embolisation site might be safer than open extraction by surgical thoracotomy, particularly in oncological patients with reduced life expectancy.
Authors:
M Pittiruti; A Cina; A Cotroneo; C Di Stasi; M Malerba; G Cina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of vascular access     Volume:  1     ISSN:  1129-7298     ISO Abbreviation:  J Vasc Access     Publication Date:  2000  
Date Detail:
Created Date:  2007-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  23-7     Citation Subset:  -    
Affiliation:
Departments of Surgery and Oncology, Catholic University, Rome - Italy.
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