BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration o...BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.展开更多
A rapamycin-eluting stent was dislodged during attempt of implantation at the proximal right coronary artery,which was found by fluoroscopy to have migrated into the anterior trunk of the left renal artery.We chose a ...A rapamycin-eluting stent was dislodged during attempt of implantation at the proximal right coronary artery,which was found by fluoroscopy to have migrated into the anterior trunk of the left renal artery.We chose a 5 mm diameter Amplatz gooseneck snare and successfully retrieved the lost stent from the lodging vessel.展开更多
Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ forma...Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients. After placing the guide wire and the loop of the gooseneck snare on each side of the tubes, the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure. The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire. We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends. Results: With in situ formation of the loop snare technique, the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min. There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium. Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels. Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.展开更多
Objective:With the increasing use of a peripherally inserted central catheter(PICC)in clinical application,the breaking of the PICC is increasing as well,which would turn into the emboli and drift to the heart and pul...Objective:With the increasing use of a peripherally inserted central catheter(PICC)in clinical application,the breaking of the PICC is increasing as well,which would turn into the emboli and drift to the heart and pulmonary artery,causing severe consequences.However,few cases have been reported on the rescue of patients with a broken PICC.Patient concerns:A 33-year-old man,diagnosed with chronic hepatitis B-related decompensated cirrhosis and cryptococcal meningitis,was treated with amphotericin B combined with flucytosine and fluconazole by means of PICC catheterization.The patient was discharged with a catheter;when he returned for re-examination,a 50cm length of PICC broke and slipped into the vein after his sudden dysphoria.First aid was immediately administered,and then the intervention therapy to extricate the tube,including pulmonary artery angiography and intravascular removal of foreign matter,was performed based on the consensus of the in-hospital vein treatment group.At last,the broken PICC fragment was successfully taken out of the vessel.Re-examination after surgery showed that he recovered well.Conclusions:Once the catheter is broken,the X-ray examination should be performed at the first instance and re-examined frequently.Moreover,the involvement of a multidisciplinary team should be formed to decide the appropriate method of treatment to ensure a successful rescue.展开更多
文摘BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.
基金supported by a grant from the Six-Major-Talent-Summit Project of Jiangsu Province,China (No. 2008-329)a grant from the New Technology Development Project of the First Affiliated Hospital of Nanjing Medical University,Nanjing,China (No. 2008-201)
文摘A rapamycin-eluting stent was dislodged during attempt of implantation at the proximal right coronary artery,which was found by fluoroscopy to have migrated into the anterior trunk of the left renal artery.We chose a 5 mm diameter Amplatz gooseneck snare and successfully retrieved the lost stent from the lodging vessel.
基金funded by the National Natural Science Foundation of China(No.81471766)
文摘Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients. After placing the guide wire and the loop of the gooseneck snare on each side of the tubes, the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure. The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire. We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends. Results: With in situ formation of the loop snare technique, the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min. There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium. Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels. Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.
文摘Objective:With the increasing use of a peripherally inserted central catheter(PICC)in clinical application,the breaking of the PICC is increasing as well,which would turn into the emboli and drift to the heart and pulmonary artery,causing severe consequences.However,few cases have been reported on the rescue of patients with a broken PICC.Patient concerns:A 33-year-old man,diagnosed with chronic hepatitis B-related decompensated cirrhosis and cryptococcal meningitis,was treated with amphotericin B combined with flucytosine and fluconazole by means of PICC catheterization.The patient was discharged with a catheter;when he returned for re-examination,a 50cm length of PICC broke and slipped into the vein after his sudden dysphoria.First aid was immediately administered,and then the intervention therapy to extricate the tube,including pulmonary artery angiography and intravascular removal of foreign matter,was performed based on the consensus of the in-hospital vein treatment group.At last,the broken PICC fragment was successfully taken out of the vessel.Re-examination after surgery showed that he recovered well.Conclusions:Once the catheter is broken,the X-ray examination should be performed at the first instance and re-examined frequently.Moreover,the involvement of a multidisciplinary team should be formed to decide the appropriate method of treatment to ensure a successful rescue.
