title: A Novel Technique Using a Protection Filter During Fibrin Sheath Removal for Implanted Venous Access Device Dysfunction.
abstract: With the increased use of implanted venous access devices (IVADs) for continuous long-term venous access, several techniques such as percutaneous endovascular fibrin sheath removal, have been described, to maintain catheter function. Most standard techniques do not capture the stripped fibrin sheath, which is subsequently released in the pulmonary circulation and may lead to symptomatic pulmonary embolism. The presented case describes an endovascular technique which includes stripping, capture, and removal of fibrin sheath using a novel filter device. A 64-year-old woman presented with IVAD dysfunction. Stripping was performed using a co-axial snare to the filter to capture the fibrin sheath. The captured fragment was subsequently removed for visual and pathological verification. No immediate complication was observed and the patient was discharged the day of the procedure.
authors.affiliation: Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Sotiriadis
authors.affiliation: Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Steven David
authors.initials: SD
authors.lastname: Hajdu
authors.affiliation: Department of Cardiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Degrauwe
authors.affiliation: Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Heloise
authors.initials: H
authors.lastname: Barras
authors.affiliation: Cardiothoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland. salah.qanadli@chuv.ch.
authors.forename: Salah Dine
authors.initials: SD
authors.lastname: Qanadli
mesh_terms: D002408:Catheters, Indwelling; D020878:Device Removal / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D005337:Fibrin; D006801:Humans; D008875:Middle Aged
chemical_list: D005337:Fibrin