RAPID-HANDLE Technique for Catheter Retrieval From the Pulmonary Artery Using a Homemade Snare With Adjustable Loop

Abstract

Introduction

Percutaneous retrieval of foreign bodies (PRFB) requires effective grasping of the foreign body and its safe removal through the sheath, a process that can be challenging. While both single loop and multi loop snare retrieval methods are available, no standard PRFB method has been established to date. This Technical Note proposes a foreign body removal technique using a homemade snare and an introducer sheath with an adjustable diameter haemostatic valve, named the Reliable grAsPing and secure retrieval of Intravascular foreign boDies with a HomemAde sNare and an introducer sheath with adjustable Diameter haemostatic valve (RAPID-HANDLE technique). This method enables safe, reliable, and efficient PRFB.

Report

A 75 year old man underwent subcutaneous infusion port placement in the right subclavian vein for gastric cancer therapy. Eight months later, radiography revealed a retained catheter fragment in the pulmonary artery. Computed tomography confirmed a 10 cm catheter fragment straddling the main trunk of the pulmonary artery. PRFB was performed the same day using a 14 F DrySeal Flex introducer sheath inserted through the right common femoral vein. A 7 F guiding catheter was positioned into the main pulmonary artery trunk and the transected end of the catheter was successfully grasped and retrieved using a homemade snare. The total procedure time was 39 minutes.

Discussion

PRFB was successfully completed with the RAPID-HANDLE technique. It is believed that this approach could serve as a standardised procedure for PRFB and is applicable to other intravascular or intracardiac cases.