Percutaneous retrieval of intravascular foreign body in children: a case series and review

• Published in: Acta radiologica (1987) 2022-05, Vol.63 (5), p.684-691
• Main Authors: Pazinato, Lucas Vatanabe, Leite, Tulio Fabiano de Oliveira, Bortolini, Edgar, Pereira, Osvaldo Ignacio, Nomura, Cesar Higa, Motta-Leal-Filho, Joaquim Mauricio da
• Format: Article
• Language: English
• Subjects: Catheterization, Peripheral; Catheters, Indwelling - adverse effects; Child; Device Removal - adverse effects; Device Removal - methods; Foreign Bodies - diagnostic imaging; Foreign Bodies - therapy; Humans; Research Design; Retrospective Studies
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1177/02841851211006904

Background Percutaneous retrieval of intravascular foreign bodies has recently increased as a treatment option. Purpose To report our single-center experience of the percutaneous retrieval of 14 intravascular embolized catheter fragments in children and to conduct a literature review. Material and Methods MEDLINE databases were searched for case reports and series including children and iatrogenic catheter fragments or guidewires retrieved through percutaneous techniques. We also conducted a retrospective analysis of 14 cases from our institution over a 14-year period. A total of 27 studies were selected comprising 74 children, plus our 14 unpublished cases. Statistical analyses were performed using Microsoft Excel version 2016. Results Port catheter fragments and peripherally inserted central catheters (PICCs) were the most embolized foreign bodies and the pulmonary artery was the most common site of embolization in 44.1% of cases. Analysis of the retrieval technique demonstrated a preference for extraction through the femoral vein (81.7%) and using snare techniques (93.5%). The success rate of percutaneous retrieval was 96.6% with only 1.1% of procedure-related complications. Patients were asymptomatic in 77.2% of cases, presented septic complications in 2.3%, and no deaths were reported. Median fluoroscopy time was 10 min (range = 1.7–80 min) and median procedure length was 60 min (range = 35–208 min). Conclusion Percutaneous retrieval of intravascular foreign bodies is a feasible, safe, and efficient technique in children and should be considered the preferred treatment option.