Successful percutaneous transvenous removal of a fractured port catheter via novel technique: Balloon-supported retrieval.
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ABSTRACT:
SUBMITTER: Dogdus M
PROVIDER: S-EPMC8443198 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Percutaneous transvenous mitral valvuloplasty (PTMV) is an established therapy for rheumatic mitral stenosis (MS). While the Wilkins score standardizes the description of valve anatomy and predicts successful PTMV, echocardiographic assessment has some limitations. The 'balloon impasse' sign is the inability to cross a stenotic valve with a deflated Inoue balloon. This sign was described in the 1990s as an indicator of severe subvalvular thickening (regardless of the echocardiographic findings), portending an increased risk of severe mitral regurgitation (MR) post-PTMV. Despite its implications for management, it has been seldom reported. A 57-year-old woman with symptomatic, severe MS and a Wilkins score of 7 underwent PTMV. The 'balloon impasse' sign was observed when attempting to cross the stenotic valve. When the balloon was fully inflated, severe MR was noted, and the patient required mitral valve replacement. This case demonstrates the continued importance of the 'balloon impasse' sign and its implications for the therapeutic efficacy of PTMV.
| S-EPMC7416822 | biostudies-literature
Project description:An entrapment and breakage of coronary angioplasty catheter during coronary intervention is a rare but serious complication. Percutaneous transluminal coronary angioplasty (PTCA) catheter got entrapped and broken inside the left anterior descending artery (LAD) in a 58-year-old male patient. The whole length of the PTCA catheter was retrieved through an arteriotomy incision in LAD along with reversed saphenous vein graft to LAD, under cardiopulmonary bypass and cardioplegic arrest. We discuss here the various percutaneous retrieval techniques and surgical management of entrapped broken PTCA catheter and also the role of transesophageal echocardiography intraoperatively.
| S-EPMC8254151 | biostudies-literature
Project description:The VIZIGO sheath (Biosense Webster, Irvine, CA, USA) is used for catheter ablation (CA) of atrial arrhythmia. In this case report, we describe a complication associated with the VIZIGO sheath and present a successful bailout method. An 82-year-old woman with paroxysmal atrial fibrillation (AF) and atrial tachycardia (AT) was referred to our hospital after experiencing palpitations for 6 months. She underwent CA using the VIZIGO sheath and a fixed Swartz sheath (St. Jude Inc., St. Paul, MN, USA). Pulmonary vein isolation and left atrial posterior wall isolation were performed to address AF and AT. Following ablation, the Swartz sheath was removed; however, the VIZIGO sheath showed resistance to removal. A wire was inserted into the VIZIGO sheath for removal, but the distal electrode ring detached in the vessel. To retrieve the electrode ring, a Mustang over-the-wire angioplasty balloon was dilated inside the ring and withdrawn with the ring. After venography and confirmation of a hemostatic seal, the ablation procedure was completed. The patient experienced postoperative anemia, which was resolved by erythrocyte transfusion. No further paroxysmal AF or AT occurred during the 1-year follow-up. In conclusion, the VIZIGO sheath's distal electrode ring may become detached during CA, and the detached ring can be successfully retrieved using our original bailout technique.Learning objectiveThis case report highlights the unique complication of electrode ring detachment associated with the novel visualized steerable sheath (VIZIGO; Biosense Webster, Irvine, CA, USA) during catheter ablation procedures and presents the successful technique as a bailout method for retrieving the dislodged ring. The technique involves dilating a non-compliant over-the-wire angioplasty balloon inside the ring and withdrawing it along with the detached ring.
| S-EPMC10865133 | biostudies-literature
Project description:Video 1Demonstration of endoscopic retrieval of fractured wire in pancreatic duct.
| S-EPMC10927605 | biostudies-literature
Project description:BackgroundPinch-off syndrome is a rare late complication characterized by the occurrence of spontaneous fracture and embolization of a port-a-cath implanted via subclavian venous access. It may lead to serious cardiovascular outcomes.Case presentationWe report a successful percutaneous transvenous removal of intravascular fractured port catheter embolized into the right ventricle by using the 'lasso' technique in an 85-year-old man with type B non-Hodgkin lymphoma undergoing chemotherapy and long estimated life expectancy.DiscussionKnowledge of pinch-off syndrome among physicians is essential for early intervention, thereby preventing adverse events. Percutaneous approach seems an effective, safe, and simple procedure.
| S-EPMC10023872 | biostudies-literature
Project description:Coronary angiography and angioplasty are relatively safe procedures but not without complications. We report an interesting case of effort angina taken for angioplasty of the LCX and assessment of fractional flow reserve (FFR) for the LAD artery lesion in which the tip of the pressure wire was broken and embolised to the LCX while trying to retrieve it. This is the first case report using a hybrid technique with a slip catheter for the successful retrieval of a fractured FFR wire.
| S-EPMC4392348 | biostudies-other
Project description:We report a rare case of crown fracture and detachment from a coronary orbital atherectomy system. During orbital atherectomy in an angulated and calcified coronary vessel, the crown was completely detached and left distal to the stenosis. It was successfully retrieved using a gooseneck snare and a guide-extension catheter. (Level of Difficulty: Advanced.).
| S-EPMC8305085 | biostudies-literature
Project description:A 75-year-old man with a previous mitral valve repair experienced embolization of a left atrial appendage occlusion device in the left atrium. The device was successfully retrieved using a double snaring technique, without the need for open surgery. This is an unusual report of left atrial appendage occluder retrieval, confirming the feasibility of the technique and the high flexibility of the device. (Level of Difficulty: Advanced.).
| S-EPMC9847238 | biostudies-literature
Project description:BackgroundPercutaneous balloon pulmonary valvuloplasty is the procedure of choice for uncomplicated severe or symptomatic pulmonary stenosis. The present study describes our experience in balloon pulmonary valvuloplasty using the Inoue balloon catheter in adolescent and adult patients.AimsTo assess the immediate and mid-term outcomes of percutaneous balloon valvuloplasty with Inoue balloon catheter in adolescent and adult patients.Methods and resultsBetween June 2010 and July 2015, we performed percutaneous balloon pulmonary valvuloplasty with Inoue balloon catheter in 32 patients (59.37% females) aged 8 to 54 years (mean 23.6±11.5). Following the procedure, the mean right ventricular systolic pressure and the pulmonary valvular peak-to-peak systolic gradient decreased from (121.6±42.4 to 61.19±24.5mmHg, p=0.001) and (100.9±43.3 to 36.4±22.5mmHg, p=0.001), respectively. Twenty patients (Group A) showed immediate optimal results with post-procedure peak systolic gradient <36mmHg while 12 patients (Group B) had suboptimal results. An increase in pulmonary regurgitation by one grade was detected in 17 patients (53.2%). Twenty-three patients available for follow-up (mean duration, 2.75 years [range 0.25-5 years]) had a mean residual peak gradient of 23.6±2.51mmHg on Doppler echocardiography with attenuation of reactive RVOT stenosis in all Group B patients. There was no further increase in grade of pulmonary regurgitation or restenosis on mid-term follow-up.ConclusionPercutaneous Inoue balloon technique is an attractive alternative with excellent mid-term results for adolescents and adults with isolated pulmonary stenosis.
| S-EPMC5415049 | biostudies-literature
Project description:Removing a foley catheter can sometimes be a challenge, especially when it is related to non-deflating balloons which represent most of the cases. In female patients, due to their urethral anatomy, several techniques have been proposed for balloon puncture when other maneuvers have failed. We present a simple technique for non-deflating balloon catheter removal in an old female patient with a permanent indwelling foley catheter which required no anesthesia. The balloon was effectively punctured with minimal patient's discomfort. In addition, this technique was tested in several ex-vivo model catheters and found to be safe and effective. Our technique can be used for non-deflating balloon puncture in female patients in an outpatient setting without anesthesia.
| S-EPMC5491744 | biostudies-other