Percutaneous Foreign Body Retrieval Research Articles

Retrieval of vascular foreign bodies using a self-made wire snare

Foreign bodies in the vascular system have a high potential to cause embolization, perforation, and infection. Therefore, numerous commercially available percutaneous retrieval devices have been developed. To evaluate the feasibility and efficacy of a self-made wire snare for the retrieval of foreign bodies in the vascular system. 16 consecutive patients, who underwent percutaneous foreign-body retrieval between 1997 and 2007, were included in this retrospective analysis. Percutaneous extraction was performed using an adjustable wire snare that was fabricated using a 5F diagnostic Headhunter or Multipurpose catheter and a 4-m-long 0.018-g/inch standard heavy-duty wire that was bent in the middle to create an eccentric loop. Percutaneous foreign-body retrieval was successful in all 16 cases. Intraluminal materials including partially fractured venous catheters, guidewires, a stent, and a vena cava filter were removed from various locations. In six cases, mobilization of the intraluminal material via a pigtail catheter was necessary before using the wire snare for removal. Successful retrieval was investigator independent. In no cases were surgical procedures required, and no relevant complications were encountered. This snare technique is an effective, feasible, and cost-effective method to retrieve intraluminal material. It is an alternative to commercially available retrieval devices.

Percutaneous Retrieval of Dislodged Port-A Catheters by Loop Retriever

Objective Port-A catheter fracture with embolization is a serious complication. The percutaneous retrieval of intravascular foreign bodies avoids the need for surgery in this high risk population. We report on 14 patients who underwent percutaneous retrieval of dislodged Port-A catheters by loop retriever. Materials and Methods Fourteen patients who had undergone percutaneous foreign body retrieval between 2002 and 2007 were evaluated retrospectively. In all procedures, retrieval of foreign bodies was performed using a 6.3-F angled wire loop retriever. Results The percutaneous retrieval procedure was successful in all 14 patients. Repositioning of the foreign body was done in seven cases using an RC1 catheter for the intracardiac Port-A catheter fragments. Additional surgery was not required. No further complications, such as damage to the vascular wall, were noted. Conclusion With the increasing use of indwelling catheters and interventional devices, we are frequently confronted with the problem of dislodged catheters. The percutaneous approach should be considered as the first choice when trying to resolve the problem of an embolized catheter in the cardiovascular system. [ Tzu Chi Med J 2008;20(1):40–43]

Nonvascular interventions of the urinary tract.

Nonvascular intervention of the urinary tract is a well-established uroradiologic subspecialty, which is more important for avoiding invasive open surgery in the age of rising demand about the value of less invasive treatment. Various kinds of nonvascular intervention are recently performed under image-guidance and are as follows: percutaneous nephrostomy, percutaneous nephrostolithotomy, percutaneous dilatation of the urinary tract, sclerotherapy for renal cysts, percutaneous catheter drainage, percutaneous foreign body retrieval and biopsy. Percutaneous nephrostomy is a basic technique to provide a direct access to urinary tract, which makes it possible to perform other interventional procedures. Although nonvascular intervention may produce some complications, it is generally considered to be less invasive than open surgery and has advantages such as short hospital stay, early return to normal life and therefore economic savings. This review is described to help clinicians easily understand the procedures, indications, techniques, and complications with figures of cases the authors experienced.

Imaging guided thoracic interventions.

Interventional Radiology is a technique based medical specialty, using all available imaging modalities (fluoroscopy, ultrasound, computed tomography, magnetic resonance, angiography) for guidance of interventional techniques for diagnostic or therapeutic purposes. Actual, percutaneous transthoracic needle biopsy includes core needle biopsy besides fine needle aspiration. Any pleural, pulmonary or mediastinal fluid or gas collection is amenable to percutaneous pulmonary catheter drainage. Treatment of haemoptysis of the bronchial artery or pulmonary artery origin, transcatheter embolization of pulmonary arteriovenous malformations and pseudoaneurysms, angioplasty and stenting of the superior vena caval system and percutaneous foreign body retrieval are well established routine procedures, precluding unnecessary surgery. These techniques are safe and effective in experienced hands. Computed tomography is helpful in pre- and postoperative imaging of patients being considered for endobronchial stenting. Many procedures can be performed on an outpatient basis, thus increasing the cost-effectiveness of radiologically guided interventions in the thorax.