Hamad Mohammed, Rajan Reynu, Kosai Nik, Sutton Paul, Das Srijit, Harunarashid Hanafiah
Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Institute of Translational Medicine, University of Liverpool, United Kingdom.
Ethiop J Health Sci. 2016 Jan;26(1):85-8. doi: 10.4314/ejhs.v26i1.14.
Complication following fracture of a central venous catheter can be catastrophic to both the patient and the attending doctor. Catheter fracture has been attributed to several factors namely prolong mechanical force acting on the catheter, and forceful removal or insertion of the catheter.
In the present case, the fracture was suspected during the process of removal. The tip of the catheter was notably missing, and an emergency chest radiograph confirmed our diagnosis of a retained fracture of central venous catheter. The retained portion was removed by the interventional radiologist using an endovascular loop snare and delivered through a femoral vein venotomy performed by the surgeon.
Endovascular approach to retrieval of retained fractured catheters has helped tremendously to reduce associated morbidity and the need for major surgery. The role of surgery has become limited to instances of failed endovascular retrieval and in remote geographical locations devoid of such specialty.
中心静脉导管骨折后的并发症对患者和主治医生来说都可能是灾难性的。导管骨折归因于几个因素，即作用于导管的长期机械力，以及导管的强行拔除或插入。
在本病例中，在拔除过程中怀疑发生了骨折。导管尖端明显缺失，紧急胸部X光片证实了我们对中心静脉导管残留骨折的诊断。介入放射科医生使用血管内圈套器取出残留部分，并通过外科医生进行的股静脉切开术取出。
血管内方法用于取出残留的骨折导管极大地有助于降低相关发病率以及减少大手术的需求。手术的作用已局限于血管内取出失败的情况以及缺乏此类专业技术的偏远地区。
