Percutaneous Retrieval of Intravascular Foreign Body: Single-Center Experience

Purpose: HCG is a tertiary care oncology center with the majority of patients requiring placement of long-term intravascular ports. Dislodgement and migration of the catheters have been encountered after long-term usage or flow at high pressure. We present our experience of 390 cases of dislodged or migrated intravascular catheters in various locations.

Materials and Methods: This is a prospective review of 390 patients (age range, 8 months–67 years) with dislodged or migrated intravascular catheters referred to the Department of Interventional Radiology for percutaneous retrieval between March 2014 and December 2020. The procedure was performed using GE Innova 41001Q in the cath lab.

Results: The catheter was dislodged into the inferior vena cava (IVC) in 180 (46.1%) patients. The catheter was seen in the right atrium (RA) extending the into the right ventricle (RV) in 60 (15.3%) cases; the pulmonary artery extending to the right hepatic vein in 45 (11.5%) cases; the superior vena cava (SVC) extending to the RA, IVC, and proximal right hepatic vein in 37 (9.6%) cases; the right internal jugular vein extending to the SVC and RA in 29 (7.5%) cases; the RA extending to the IVC in 21 (5.4%) cases; and the RV in 18 (4.6%) cases. The mechanisms of endovascular loss were device fracture in 60 (15.3%) cases and migration in 330 (84.6%) cases. Snare was used to remove the intravascular foreign body (IVFB) in 120 (30.7%) cases, and a combination of pigtail catheter and snare was used in 270 (69.2%) cases. Technical success was achieved in 100% of cases. There were no immediate complications related to the retrieval of the IVFB.

Conclusions: Percutaneous retrieval of IVFBs is a minimal invasive and better alternative to surgery because of its high success rate and minimal morbidity.