A modified two-step technique for the retrieval of a chemoport catheter fragment with inaccesible ends

Abstract

BackgroundMigration of central venous catheters is a rare but serious complication. The endovascular approach has been widely used for the retrieval of such fragment, with the two-step technique used for removal of catheter fragments with inaccessible ends. In this case report, we describe a modification of this technique that was used after first attempting the two-step technique unsuccessfully.Case presentationA 42-year-old female withbreast cancer had a chemoport inserted for chemotherapy. After 6 cycles ofchemotherapy the port could not be flushed and a chest radiograph demonstrateda migrated catheter fragment. CT scan demonstrated that one end of the fragmentwas in the liver in the middle hepatic vein and the other in the right atrialappendage. A modified 2 step technique, using a pigtail catheter, hydrophilicwire and snare was used to remove this fragment.ConclusionIn this case report wehighlight a new modification of the 2-step technique that can be employed whenthe conventional 2 step technique does not work.