title: Successful Image-Guided Retrieval of an Embolized Fragment of a Fractured Haemodialysis Catheter Tip from the Pulmonary Artery.
abstract: BACKGROUND
  Cuffed, double-lumen, tunneled haemodialysis catheters are a common means of vascular access in paediatric haemodialysis, particularly in infants. Haemodialysis catheter fracture with distal embolization is a rare complication.
  
  
  METHODS
  A 2-year-old boy was receiving chronic haemodialysis via a right internal jugular cuffed, double-lumen, tunneled haemodialysis catheter, inserted 3 months previously. He was asymptomatic and was incidentally found to have had embolization of a fractured catheter tip into a segmental branch of the left pulmonary artery. The catheter was replaced and the embolized fragment successfully retrieved, non-surgically, using an image-guided endovascular approach with a loop snare device.
  
  
  CONCLUSIONS
  Haemodialysis catheter fracture with distal embolization is a rare complication in both adults and children and is usually associated with prolonged use and catheter fatigue. Retrieval of the embolized fragment should always be attempted to prevent possible complications. Awareness of this potential complication is important to facilitate diagnosis and management.
authors.affiliation: Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Chia Wei
authors.initials: CW
authors.lastname: Teoh
authors.affiliation: Image-Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Avnesh S
authors.initials: AS
authors.lastname: Thakor
authors.affiliation: Image-Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Joao G
authors.initials: JG
authors.lastname: Amaral
authors.affiliation: Image-Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Parra
authors.affiliation: Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Harvey
authors.affiliation: Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, Ont., Canada.
authors.forename: Damien G
authors.initials: DG
authors.lastname: Noone
keywords: Diagnostic imaging; Dialysis; Dialysis catheter; Embolism; Interventional radiology; Paediatric nephrology; Renal medicine