Retrieval of intravascular foreign bodies with goose neck snare
Introduction
With the increasing use of indwelling catheters and interventional device, interventional radiologists are frequently confronted with the problem of percutaneous retrieval of foreign bodies [1], [2], [3], [4], [5], [6], [7], [8], [9], [10]. Since its first description, the percutaneous retrieval of intravascular foreign bodies has become a frequently applied technique. Many devices have been used as tools to retrieve various types of intravascular objects—snares, grasping forceps, baskets, tip-deflecting wires, pincher devices, over sheaths, balloon catheters [4], [6], [9], [11]. The loop snare technique has been used in most of cases as a primary choice. With the introduction of the nitinol goose neck microsnare, the disadvantage of a parallel-opening, self-made wire snare was overcome. Although earlier reports concentrated on objects such as broken catheters, vena cava filters and guide wires, today, the spectrum of endoluminal foreign objects has broadened to include items such as embolization coils and endovascular stent components.
Despite extensive experience with percutaneous retrieval of intravascular foreign bodies, relatively few large series have been reported in the literature, and most of the information is published as case reports. Based on our experience with 15 patients, we report on the strategies, methods, success rate and techniques of percutaneous retrieval of intravascular foreign bodies.
Section snippets
Materials and methods
Fifteen patients who had undergone percutaneous foreign body retrieval between 1998 and 2001 were evaluated retrospectively. These patients’ age were ranging from 15 to 65 years.
Indications for interventional retrieval included broken catheters, introducer fragment, microcoil dislocation, stent dislocation, guide-wire fragment and a fragment of pacemaker transducer. In each instance of diagnostic angiography and in each interventional procedure, such as embolization or placement of a stent, the
Results
The percutaneous retrieval procedure was successful in all of the 15 patients (Table 1). No other methods of removal (i.e. with different device or technique) were attempted. Additional surgery was not required. There were no significant complications related to the procedure.
Seven fractured port catheters occurred in patients who had been treated because of osteosarcoma, colon tumor and mediastinal tumor. In the six of seven patients, fractured catheters were extracted from right atrium and
Discussion
Percutaneous treatment of intravascular foreign bodies has been used as a safe and effective procedure in numerous patients. The spectrum of percutaneously removed foreign bodies has significantly broadened since its first description [1]. In addition to fractured catheter and guide wire, today, migrated stens, misplaced coils can be removed percutaneously. The wire loop snare, retrieval basket, grasping forceps, deflecting wire, pincher device, oversize sheath or catheter and balloon catheter
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