A Novel Approach for the Retrieval of Broken Catheter Fragment – Using Balloon Dilatation Technique

Abstract

In this era of an ever increasing number of interventions in cardiology, there is a parallel increase in the number of complications associated with these interventions, such as broken catheter tip and guide wire embolisation. The most commonly used and effective method for the percutaneous retrieval of such broken fragments is a goose neck snare. However in cases where this technique has been a failure, newer and novel innovations have been implemented for the retrieval of such broken fragments. We present a case of seven-year-old female child with a 3mm peri-membranous ventricular septal defect who was taken up for device closure. During the procedure the internal mammary catheter was broken in the left ventricle and subsequently the broken fragment was embolised to the left common carotid artery. The broken fragment was snared down upto the common iliac but could not be retrieved out of the sheath. A novel approach was used, consisting of negotiating a coronary guide wire across the broken catheter and inflating a balloon in the catheter fragment which helped to achieve a co-axial alignment with the arterial sheath and hence by which it was possible to retrieve the broken catheter fragment out of the circulatory system.

Keywords

• common carotid artery
• embolisation
• foreign body
• ventricular septal defect