title: Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System.
abstract: OBJECTIVE
  To describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.
  
  
  METHODS
  Between May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.
  
  
  RESULTS
  Mean FB size was 23 mm (range 8-74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.
  
  
  CONCLUSIONS
  Percutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France. gigicazzato@hotmail.it.
authors.forename: Roberto Luigi
authors.initials: RL
authors.lastname: Cazzato
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Garnon
authors.affiliation: Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
authors.forename: Nitin
authors.initials: N
authors.lastname: Ramamurthy
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Georgia
authors.initials: G
authors.lastname: Tsoumakidou
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Caudrelier
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Marie-Aude
authors.initials: MA
authors.lastname: Thénint
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Pramod
authors.initials: P
authors.lastname: Rao
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Koch
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l'Hôpital, 67000, Strasbourg, France.
authors.forename: Afshin
authors.initials: A
authors.lastname: Gangi
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D002404:Catheterization; D003452:Cryosurgery / Q000295:instrumentation*; D005260:Female; D005471:Fluoroscopy; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D064847:Multimodal Imaging; D009339:Needles; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty
chemical_list: D019904:Polymethyl Methacrylate
keywords: Foreign bodies; Interventional radiology; Non-vascular