Case 2: Retrieval of a cut central venous catheter from the right atrium. Ken U. Ekechukwu, MD, MPH, FACP.

Foreign bodies such as guidewires and catheters sometimes break off their parent body and travel through the blood stream to another site. This can happen in the process of removing them from or inserting them into the body. When it happens the embolized pieced should be removed from the body if it is safe to do so.

This patient had a dialysis unit composed of two large tunneled hemodialysis catheters inserted into his right atrium and attached to two subcutaneous chest ports. The unit malfunctioned and had to be replaced with a composite dual-lumen dialysis catheter. During their removal, however, one of the catheters was unintentionally cut and its leading piece, irretrievable by blunt tissue dissection, had to be fished from the patient with a snare that I introduced into his right atrium through his right common femoral vein.

The first image below shows the initial dialysis unit before removal; the second is an image of the snaring and retrieval process; while the third is a final image of the new dual-lumen dialysis catheter after its insertion.

Retrieval_of_central_venous_catheter_1 Retrieval_of_central_venous_catheter_2 Retrieval_of_central_venous_catheter_3