title: Interventional radiological retrieval of embolized vascular access device fragments.
abstract: OBJECTIVE
  Vascular access device fragment embolization is a relatively rare but potentially serious complication. The purpose of this study was to report our experience with endovascular retrieval of embolized vascular access device fragments by interventional radiological means.
  
  
  METHODS
  Ten patients with a vascular access device fragment embolism were treated between 2004 and 2010. Attempted retrieval from the vascular bed was performed for five port catheter fragments, two temporary catheter fragments and three guide wires. The demographic data, underlying disease of the patients, type of inserted catheters, interval between implantation and discovery of embolism, interval between discovery of embolization and retrieval and localization and length of the embolized fragments were identified from the patient charts.
  
  
  RESULTS
  In nine of the ten patients (90%), radiologic intervention retrieval of the embolized vascular access device fragments was successful. The reasons for intravascular fragment embolism consisted of rupture at the connection site of the chamber or the external hub and the intravascular catheter (n=4), pinchoff syndrome (n=3), operator inexperience (n=3). Embolized catheter fragments or guide wires were retrieved under fluoroscopy by a gooseneck snare. The postprocedural course was uneventful.
  
  
  CONCLUSIONS
  The radiological retrieval of embolized vascular access device fragments is the preferred method, and it has a high success rate. Considering the potential for devastating complications, patients should be referred to interventional radiology, and the embolized catheters should be retrieved using interventional endovascular techniques.
authors.affiliation: Department of Radiology, Gazi University School of Medicine, Ankara, Turkey. baranonal@gazi.edu.tr
authors.forename: Baran
authors.initials: B
authors.lastname: Önal
authors.forename: Bilgen
authors.initials: B
authors.lastname: Coşkun
authors.forename: Ramazan
authors.initials: R
authors.lastname: Karabulut
authors.forename: Erhan T
authors.initials: ET
authors.lastname: Ilgıt
authors.forename: Zafer
authors.initials: Z
authors.lastname: Türkyilmaz
authors.forename: Kaan
authors.initials: K
authors.lastname: Sönmez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D004617:Embolism / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies