Transjugular removal of an intravascular catheter fragment using a snare loop catheter

Abstract

Central venous catheters are widely used for various purposes, including central venous pressure measurement, total parenteral nutrition, blood sampling, transfusion of blood products, chemotherapy or long-term antibiotic therapy. Catheter fragmentation, a rare complication, results in an urgent interventional or surgical removal. The distal tip of a femoral catheter was accidentally severed in a 4-month-old girl with the diagnosis of tetralogy of Fallot after emergency shunt operation. Posteroanterior X-ray revealed a catheter fragment in the left iliac vein. The fragment was successfully removed transjugularly through a sheath inserted into the right internal jugular vein advanced through vena cava superior, the right atrium and vena kava inferior, using a 4F Amplatz Goose Neck Snare catheter. No complication was seen during the procedure. Transcatheter removal of the foreign body is a safe and effective method. It is possible to remove the foreign body through several arterial and venous routes. In selected patients, transjugular route can be preferred to capture the foreign body thanks to its ease of access of and appropriate angle.