Percutaneous Retrieval of a Fragmented Port-a-Cath With the Snaring Technique

Hossein Farshidi,Dariush Hooshyar,Moazameh Mohammadi Soleimani

doi:10.34172/ddj.2021.32

Abstract

Background: Long-term use of central venous catheters is common in cancer patients for chemotherapy. The remaining of these catheters after the end of the treatment period can be associated with complications such as thrombosis and catheter fragmentation. Case Report: This report presents a 42-year-old woman with a history of colon cancer whose inner part of the vascular access was detached from the outer part after removing the central venous catheter, and the catheter remained inside the internal jugular vein. After preparing the patient’s chest X-ray, the catheter was removed from the femoral vein by percutaneous retrieval and successfully taken out using the snaring technique. Conclusion: Overall, percutaneous retrieval is a safe way to remove intravascular foreign bodies that can prevent major surgical complications.

Highlights

Port-A-cath is an implantable tool that can be used to provide frequent intravenous access to prescribe parenteral medications, fluids, nutrients, blood sampling, and long-term chemotherapy [1].The device consists of two parts, the outer and inner ports, which are often made of titanium and polyurethane or silicone, respectively [2].Prolonged use of port-a-cath may lead to complications such as infection, occlusion of blood vessels, internal bleeding, blood clots, and extravasation [1]
While the end of the proximal catheter was attached to the right internal jugular vein, the distal end of the catheter was taken under a fluoroscopic view with SNARE 6S and successfully removed through a percutaneous sheath introducer (Figure 2), and a prophylactic antibiotic was prescribed to the patient
Jugular vascular wall fibrosis and endothelialization are some of the reasons for justifying the catheter adhesion at the implant site [4], but the therapeutic results of this case require further research on vascular fibrosis in cancer patients treated with intravenous access

Summary

Introduction

Port-A-cath is an implantable tool that can be used to provide frequent intravenous access to prescribe parenteral medications, fluids, nutrients, blood sampling, and long-term chemotherapy [1]. Prolonged use of port-a-cath may lead to complications such as infection, occlusion of blood vessels, internal bleeding, blood clots, and extravasation [1]. It is withdrawn after the end of the medication period or in situations where there is no longer a need for vascular access [3]. While the end of the proximal catheter was attached to the right internal jugular vein, the distal end of the catheter was taken under a fluoroscopic view with SNARE 6S and successfully removed through a percutaneous sheath introducer (Figure 2), and a prophylactic antibiotic was prescribed to the patient

Discussion

Conclusion