TWO CASES OF TRANSCUTANEOUS REMOVAL OF IVH CATHETER FARGMENTS IN THE RIGHT SIDE CIRCULATORY SYSTEM

Abstract

In this paper two cases that IVH catheter fragments in the right side circulatory system were transcutaneously removed are reported. Case 1 is an 18-year-old man who was hospitalized for traumatic intracerebral hemorrhage. He pulled out a IVH catheter indwelling in the right subclavian vein by himself, when the catheter was broken and the fragment of it entered through the supra vena cava into right side circulatory system. Case 2 is a 47-year-old woman hospitalizing for cerebral infarction. She also pulled out the catheter by herself. In both cases, catheter fragments were transcutaneously removed by using a basket catheter via the right femoral vein.It is probable that IVH catheter frequently entered into right side circulatory system in daily medical care. In Japan, only 51 cases that IVH catheter fragments in the right side circulatory system were transcutaneously removed have been reported. The most common mechanism for loss of the catheter was iatrogenic (14 cases), followed by spontaneous break by patients (8 cases). In the all 51 cases the mean age was 47 years and the male-to-female ratio was 2:1, versus 58 years and 5:1 in spontaneous break cases. It can be said that spontaneous break commonly occurred in aged men. In Japan snare loop catheters via the right femoral vein are most commonly used for removals of fragments.