Name of the Procedure:

Transcatheter Retrieval, Percutaneous, of Intravascular Foreign Body
Common name(s): Transcatheter Foreign Body Retrieval
Technical term: Percutaneous Intravascular Foreign Body Retrieval

Summary

Transcatheter retrieval is a minimally invasive procedure used to remove foreign objects, such as broken catheters, from blood vessels. The process involves using imaging technology like ultrasound or fluoroscopy to guide the retrieval device through the vascular system and extract the foreign body.

Purpose

The procedure addresses the presence of foreign objects in blood vessels, which can cause complications such as infection, thrombosis, or impaired blood flow. The goal is to safely remove these objects to prevent further medical issues and restore normal vessel function.

Indications

• Presence of a fractured venous or arterial catheter
• Retained intravascular devices or wires
• Symptoms of obstruction, such as swelling, pain, or impaired blood flow
• Risk of infection or thrombosis due to the foreign body

Preparation

• Patients may need to fast for several hours before the procedure.
• Blood tests and imaging studies may be required to locate the foreign body and assess vascular health.
• Patients should discuss any medications with their doctor, as certain drugs may need to be adjusted.

Procedure Description

1. The patient is typically given local anesthesia and mild sedation.
2. Using ultrasound or fluoroscopy, a catheter is guided into the blood vessel through a small incision.
3. A retrieval device, such as a snare or forceps, is fed through the catheter to grasp and remove the foreign body.
4. Continuous imaging ensures accurate navigation and extraction.
5. Once the foreign body is removed, the catheter is withdrawn, and the incision site is closed.

Duration

The procedure typically takes between 30 minutes to 2 hours, depending on the complexity and location of the foreign body.

Setting

Transcatheter retrieval is usually performed in a hospital's radiology suite or an outpatient clinic equipped with appropriate imaging facilities.

Personnel

• Interventional radiologist or a vascular surgeon
• Radiology technicians
• Nurses specializing in procedural care
• Anesthesiologist or sedation nurse, if general anesthesia or moderate sedation is used

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Vessel damage or perforation
• Embolization of the foreign body fragment
• Allergic reactions to contrast agents used in imaging
• Rarely, retained fragments requiring additional intervention

Benefits

• Minimally invasive with quicker recovery compared to open surgery
• High success rate in removing foreign objects
• Reduced risk of complications associated with retained intravascular foreign bodies
• Immediate relief of symptoms and prevention of further complications

Recovery

• Patients may need to stay under observation for a few hours post-procedure.
• Mild soreness at the incision site is common.
• Patients are usually advised to avoid strenuous activities for a few days.
• Follow-up imaging may be scheduled to ensure complete removal and assess healing.

Alternatives

• Open surgical removal of the foreign body
  • Pros: Direct visualization and potentially easier retrieval for complex cases
  • Cons: More invasive, longer recovery time, and higher risk of complications
• Conservative management (e.g., monitoring if the foreign body poses no immediate risk)
  • Pros: Non-invasive, avoiding procedural risks
  • Cons: Potential for complications if the foreign body migrates or causes obstruction/infection

Patient Experience

• During the procedure, the patient might feel pressure but little to no pain due to local anesthesia.
• Post-procedure, mild soreness and bruising at the insertion site are common.
• Pain management with over-the-counter pain relievers as advised.
• Detailed instructions for care and activity restrictions will be provided to facilitate recovery.