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取出栓塞的外周静脉穿刺中心静脉导管——一种新颖的两步技术。

Retrieving embolized peripherally inserted central catheter - A novel two step technique.

作者信息

Sood Shikha, Srinivasan S

机构信息

Department of Radiodiagnosis, Indira Gandhi Medical College (IGMC), Shimla 171001, Himachal Pradesh, India.

出版信息

Radiol Case Rep. 2021 Dec 16;17(3):531-536. doi: 10.1016/j.radcr.2021.11.044. eCollection 2022 Mar.

Abstract

We report a novel two-step percutaneous endovascular technique for retrieval of peripherally inserted central catheter, free ends of which were inaccessible, that had embolized to the segmental branch of left pulmonary artery using SIM 1 catheter and a loop snare, in a 17 year old female patient diagnosed with osteosarcoma right femur. Step one involved, inserting SIM 1 catheter through the heart to hook the embolized peripherally inserted central catheter and bring it down to the lower segment of inferior vena cava. In the second step, a loop snare was used to grasp the free end of peripherally inserted central catheter, and the whole assembly was withdrawn via right common femoral vein access. Patient was monitored for 24 hours and discharged as there were no complications. SIM 1 catheter followed by the use of loop snare as a retrieval system is safe and efficacious and can be considered by an intervention radiologist for retrieval of embolized vascular access device, in which none of the free ends are available to catch hold with a loop snare.

摘要

我们报告了一种新颖的两步经皮血管内技术,用于取出外周置入中心静脉导管(PICC),该导管的游离端无法触及,已栓塞至左肺动脉的节段分支。在一名诊断为右股骨骨肉瘤的17岁女性患者中,使用SIM 1导管和圈套器进行了该操作。第一步,将SIM 1导管经心脏插入,钩住栓塞的外周置入中心静脉导管,并将其拉至下腔静脉下段。第二步,使用圈套器抓住外周置入中心静脉导管的游离端,然后通过右股总静脉通路将整个组件取出。对患者进行了24小时监测,由于没有并发症,患者出院。以SIM 1导管随后使用圈套器作为取出系统是安全有效的,对于栓塞的血管通路装置的取出,介入放射科医生可以考虑采用这种方法,因为该装置的游离端均无法用圈套器抓住。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd21/8688964/e77ddfdc7f02/gr1.jpg

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