title: Repositioning of surgically placed peritoneovenous shunt catheter by forming "in situ" loop snare: case report and review of literature.
abstract: We describe a technique that allows repositioning of malfunctioning peritoneovenous shunt (PVS) catheters. We report a 67-year-old female with refractory ascites, who presented with malfunctioning PVS. The catheter tip was outside the superior vena cava (SVC), possibly in a small mediastinal vein, which makes its tip inaccessible to regular snares and retrieval devices. We used "in situ" loop snare technique to reposition the tip of the catheter into the inferior vena cava (IVC). In situ loop snare technique can be used to reposition malfunctioning PVS catheters caused by a kink or by malposition of its tip. The technique avoids surgical or interventional replacement of these catheters. This technique can be also used for retrieval of foreign body fragments that have no free ends and, therefore, cannot be captured by a snare or other retrieval devices.
authors.affiliation: Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA. akamel@uabmc.edu
authors.forename: Ahmed Kamel
authors.initials: AK
authors.lastname: Abdel Aal
authors.forename: Jayesh
authors.initials: J
authors.lastname: Soni
authors.forename: Souheil
authors.initials: S
authors.lastname: Saddekni
authors.forename: Maysoon F
authors.initials: MF
authors.lastname: Hamed
authors.forename: Derek A
authors.initials: DA
authors.lastname: Dubay
mesh_terms: D000368:Aged; D001201:Ascites / Q000628:therapy*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D010536:Peritoneovenous Shunt / Q000009:adverse effects / Q000295:instrumentation*; D010690:Phlebography; D015641:Radiography, Interventional; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging