Percutaneous retrieval of a central venous catheter sutured to the wall of the inferior vena cava

A central venous catheter was sutured to the wall of the inferior vena cava in a 20-year-old male undergoing retroperitoneal lymphadenectomy for malignant testicular germ cell tumor. We succeeded in retrieving the catheter percutaneously, using a combination of loopsnare wire and myocardial biopsy forceps.     

Percutaneous retrieval of a strecker stent misplaced during TIPS

During a transjugular intrahepatic portosystemic shunt (TIPS) procedure, a Strecker stent was accidently pushed into the superior mesenteric vein. After successful shunt placement, the stent was withdrawn into the hepatic vein. A multipurpose basket catheter was attached to the distal end of the stent and a loop snare to the proximal end. In this way it was possible to stretch the stent and retrieve it percutaneously through the jugular sheath.     

Percutaneous retrieval of a fractured surgical drain from the deep perineal soft tissues: Technical note

A case is presented in which a fragment of a surgical drain was retrieved from the deep presacral soft tissues using interventional techniques originally evolved for intravascular retrieval, thereby avoiding reoperation.     

Percutaneous retrieval of a misplaced titanium Greenfield filter

Vena caval filters are considered permanent indwelling devices. Occasionally, malposition of a filter prompts a desire for its removal. We report a method of percutaneous retrieval of a titanium Greenfield filter by snare.     

Retrieval of a guidewire introducer by catheter-capture from the proximal inferior vena cava: Technical note

We report a case of a retrieval of an iatrogenically placed guidewire introducer from the proximal stump of an obstructed inferior vena cava. The retrieval of the foreign body was achieved by a technique that we have named the “catheter-capture technique.”     

Strecker stent migration to the pulmonary artery: long-term result of a “wait-and-see attitude”

Accidental dislodgement of an endoprosthesis into the right cavities or the pulmonary artery is a rarely described complication of percutaneous venous stenting. In such cases the migrated stent needs to be promptly extracted by percutaneous techniques in order to avoid any major complication. We report the first case of a delayed Strecker stent migration from the left inominate vein into the right pulmonary artery, successfully managed with anticoagulant therapy and a “wait-and-see” attitude. The advanced stage-disease (metastatic cancer patient) and the large-caliber stent in a disease-free pulmonary artery led us to adopt this unorthodox attitude, as compared with the current clinical practice. Received: 26 May 2000 Revised: 11 August 2000 Accepted: 11 August 2000     

Percutaneous retrieval of a retained Jackson-Pratt drain fragment

A retained intraabdominal Jackson-Pratt drain fragment was percutaneously retrieved using an inflated angioplasty balloon that had been maneuvered inside of the drain lumen over a hydrophilic-coated steerable guidewire.     

Percutaneous Retrieval of a Central Venous Catheter Sutured to the Wall of the Right Atrium

A transjugular central venous catheter was inadvertently sutured to the wall of the right atrium in a 63-year-old female during coronary bypass surgery. Using two nitinol Goose Neck snares via a transfemoral and a transjugular approach the catheter was severed into two pieces and retrieved percutaneously.     

In situ formation of a loop snare for retrieval of a foreign body without a free end

A technique is described that allowed percutaneous retrieval of an endoscopically placed, obstructed biliary stent using loop snare capture of an angled hydrophilic wire which was wrapped around the stent initially.     

Entrapment of J-Tip guidewires by venatech and stainless-steel greenfield vena cava filters during central venous catheter placement: Percutaneous management in four patients

We present four patients in whom beside placement of a central venous catheter was complicated by entrapment of a J-tip guidewire by a previously placed vena cava (VC) filter. Two Venatech filters were fragmented and displaced into the superior VC or brachiocephalic vein during attempted withdrawal of the entrapped wire. Two stainless-steel Greenfield filters remained in place and intact. Fluoroscopically guided extraction of both wires entrapped by Greenfield filters was successfully performed in the angiography suite.     

Percutaneous retrieval of an impacted ureteric T-tube

An impacted ureteric T-tube was removed percutaneously, using an Amplatz goose-neck snare. This new snare has advantages over conventional snares, particularly in situation where atraumatic manipulation is essential. Correspondence to: R. D. Edwards     

Percutaneous removal of intravascular foreign bodies

Catheter and guidewire fragments left remaining in the cardiovascular system induce a high incidence of morbidity. Percutaneous removal of these fragments was attempted in 13 patients, with complete success in 10, partial success in two, and the fragment was extraluminal in one patient. Technique of foreign body removal and problems encountered are discussed.     

Percutaneous treatment of intrabdominal abscess: urokinase versus saline serum in 100 cases using two surgical scoring systems in a randomized trial

The purpose of this study was to assess whether regular instillation of urokinase during abscess drainage leads to an improved outcome compared to saline irrigation alone. One hundred patients referred for image-guided abdominal abscess drainage were randomized between thrice daily urokinase instillation or saline irrigation alone. At the end of the study, patient medical records were reviewed to determine drainage, study group, Altona (PIA II) and Mannheim (MPI) scoring, duration of drainage, procedure-related complications, hospital stay duration, and clinical outcome. The technical success rate of the percutaneous abscess drainage was 100%. The success or failure of abscess remission did not differ significantly between groups (success rate of 91.5% in the urokinase group vs. 88.8% in the saline group; failure rate was of 8.5 vs. 21.2%, respectively); however, days of drainage, main hospital stay, and overall costs were significantly reduced in patients treated with urokinase compared to the control group (P < 0.05). No adverse effects from urokinase were observed. Surgical scores were a useful homogeneity factor, and MPI showed a good correlation with prognosis, while PIA results did not have a significant correlation. For drainage of complex abscesses (loculations, hemorrhage, viscous material), fibrinolytics safely accelerate drainage and recovery, reducing the length of the hospital stay and, therefore, the total cost.     

Percutaneous Sacroplasty for Sacral Metastatic Tumors Under Fluoroscopic Guidance Only

Percutaneous sacroplasty is a safe and effective procedure for sacral insufficient fractures under CT or fluoroscopic guidance; although, few reports exist about sacral metastatic tumors. We designed a pilot study to treat intractable pain caused by a sacral metastatic tumor with sacroplasty. A 62-year-old man and a 38-year-old woman with medically intractable pain due to metastatic tumors of S1 from lymphoma and lung cancer, respectively, underwent percutaneous sacroplasty. Over the course of the follow-up period, the two patients experienced substantial and immediate pain relief that persisted over a 3-month and beyond. The woman had deposition of PMMA (polymethyl methacrylate) in the needle track, but did not experience significant symptoms. No other peri-procedural complications were observed for either patient.     

Nonsurgical retrieval of an accidentally dislodged vent catheter retention ring

During open mitral commissurotomy in a patient with mitral stenosis, a vent catheter retention ring was accidentally slipped off into the left atrium and lodged near the orifice of the right renal artery. Nonsurgical retrieval of this intraarterial foreign body was performed successfully under fluoroscopic guidance in the operating room using a combined approach of angiographic catheters and guidewire, these being inserted via the arteriotomy site of the right femoral artery created for cardiopulmonary bypass.     

Transarterial Embolization with Berenstein Liquid Coils and N-butyl Cyanoacrylate in a Vein of Galen Aneurysmal Malformation: a Case Report

A 12-week-old baby with a vein of Galen aneurysmal malformation (VGAM) was successfully treated with performing transarterial microcatheter-directed embolization with Berenstein Liquid Coils and n-butyl cyanoacrylate in the feeding arteries. Post-procedure angiography showed a marked decrease of the blood flow into the dilated vein of Galen. Three months later, follow-up angiography showed that the vein of Galen aneurysmal malformation had totally disappeared, and the baby recovered very well without any sequelae. We report here on this interesting case along with a review of the relevant literature, and we aim to enhance physicians'' awareness of the treatment for VGAMs.     

Percutaneous transgastric cystoduodenostomy in the treatment of a pancreatic pseudocyst: A new approach

A case of an infected pseudocyst in the head of the pancreas is presented. Due to its small size and fistulization to the duodenum, a drainage catheter was placed through the fistulous tract from a distant transgastric approach. The fistula was balloon dilated to improve its emptying. Sixteen months later the patient remains asymptomatic with no recurrence of the pseudocyst.     

Percutaneous removal of a biliary stent after acute spontaneous duodenal perforation

A 38-year-old woman was treated for malignant stricture by the endoscopic placement of a biliary endoprosthesis. She developed a large retroperitoneal biloma secondary to acute duodenal perforation by the stent. We describe the successful percutaneous retrieval of the biliary stent through a retroperitoneal approach which also permitted drainage of the biloma.     

Ultrasound-Guided Percutaneous Removal of Wooden Foreign Bodies in the Extremities with Hydro-Dissection Technique

ObjectiveWe described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases.ResultsThe mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance.ConclusionUltrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.     

Percutaneous treatment of pyogenic liver abscess: A critical analysis of results

Nineteen patients who had pyogenic liver abscesses underwent percutaneous treatment assisted by computed tomography. Percutaneous drainage was performed with Fr 8-14 catheters in 12 patients and percutaneous aspiration in 7 patients. A solitary abscess was present in 15 patients and multiple abscesses were present in 4. The average drainage duration was 26 days. Successful treatment was obtained in 16 of 19 (84%) cases. One abscess recurred and was cured by repeat drainage. Two patients died. Reviewing 14 reports from the literature with a total of 252 patients treated percutaneously, an overall success rate of 77% and a mortality rate of 6% was found.