Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
J Endovasc Ther. 2021 Jun;28(3):474-480. doi: 10.1177/15266028211007470. Epub 2021 Apr 15.
Intravascular embolization of hemodialysis and central venous catheters is a rare but potentially serious complication. With the increasing use of catheters in medical practice, we are often faced with this type of complication. Novel, simple, and low-cost techniques are needed for foreign body extraction in order to reduce cardiovascular risks.
We describe the approach of 5 foreign body embolization cases. Case 1: a 57-year-old woman with end-stage renal failure with a complete fracture and migration of the distal extremity of a hemodialysis catheter. Case 2: a 55-year-old man with an accidental embolization of the distal portion of a hemodialysis catheter. Case 3: a 76-year-old woman with stage IV breast cancer and an accidental embolization of a central venous catheter guidewire. Cases 4 and 5: a 71-year-old woman and a 2-year-old boy with a port-a-cath embolization. All the patients underwent successful minimally invasive removal of the foreign bodies from the thoracic site using 5Fr pigtail catheters. Additional surgery was not required. No further complications, such as damage to the vascular wall, were noted.
Our experience with the interlacing and traction pigtail show that it is a simple, practical, and low-cost technical alternative and its benefits should be widespread.
血液透析和中心静脉导管的血管内栓塞是一种罕见但潜在严重的并发症。随着导管在医学实践中的广泛应用,我们经常会遇到这种类型的并发症。为了降低心血管风险,需要采用新颖、简单且低成本的技术来提取异物。
我们描述了 5 例异物栓塞病例的处理方法。病例 1:一名 57 岁女性,终末期肾病,血液透析导管的远端完全断裂并迁移。病例 2:一名 55 岁男性,血液透析导管的远端意外栓塞。病例 3:一名 76 岁女性,患有 IV 期乳腺癌,中心静脉导管导丝意外栓塞。病例 4 和病例 5:一名 71 岁女性和一名 2 岁男孩,发生输液港导管栓塞。所有患者均成功地使用 5Fr 猪尾导管经微创方式从胸部取出异物。无需进一步手术。未观察到血管壁损伤等进一步并发症。
我们使用交错牵引猪尾导管的经验表明,这是一种简单、实用且低成本的技术选择,其益处应该得到广泛应用。