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Case Reports
. 2006 Sep;21(3):187-90.
doi: 10.3904/kjim.2006.21.3.187.

Transluminal removal of a fractured and embolized indwelling central venous catheter in the pulmonary artery

O Kil Kim  1 , Su Hong Kim, Jong Bin Kim, Woo Seong Jeon, Sung Hwan Jo, Jee Hyun Lee, Ji Ho Ko
Affiliations
Case Reports

Transluminal removal of a fractured and embolized indwelling central venous catheter in the pulmonary artery

O Kil Kim et al. Korean J Intern Med. 2006 Sep.

Abstract

Vascular catheters are associated with complications such as infection, thrombosis and stenosis. The embolization of a venous catheter fragment is a rare complication. A 39-year-old woman underwent placement of a totally implantable venous access device for chemotherapy to treat a recurrent liposarcoma of the left thigh. The "pinch-off sign" was noted on a routine chest X-ray but that was ignored. Three-months after implantation of the intravenous access device, the indwelling central catheter was fractured and embolized to the pulmonary trunk. The catheter in the pulmonary trunk was successfully removed through a percutaneous femoral vein approach using a pigtail catheter and goose neck snare.

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Figures

Figure 1
Figure 1
Chest X-ray shows minimal luminal narrowing of the catheter (arrow).
Figure 2
Figure 2
A. Fracture of the catheter over the first rib and beneath the clavicle (arrow), B. Fractured and embolized catheter in the pulmonary artery (arrow).
Figure 3
Figure 3
Computed tomography of the chest confirmed the catheter artifact in the pulmonary artery (arrow).
Figure 4
Figure 4
Successful grasping and retrieval of the venous catheter fragment. (A) Fragmented catheter in the pulmonary artery (arrow). (B) Failed retrieval of the fragment using a H1 catheter and snare (arrow). (C) and (D) Successful grasping and retrieval of the fragment using a pigtail catheter and snare (arrow).
Figure 5
Figure 5
The 15 cm sized fragmented catheter after successful retrieval.
See this image and copyright information in PMC

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