1Atif Iqbal Rana,1Zahid Amin Khan, 1Zahid Amin Khan, 1Haider Ali, 1Jamshaid Anwar
1Shifa International Hospital
Long term venous access in infants is now been increasingly achieved using peripherally inserted central catheters(PICC). These lines are generally considered safe however associated complications should also be kept in mind. Among those; line breakage and migration can occur in 1% which requires immediate removal to avoid life threatening complications.
Material(s) and Method(s):
To our knowledge, only scarce case reports published previously successfully retrieved intra cardiac broken PICC lines under fluoroscopic guidance in preterm low birth weight infants. Here we present a case of successful percutaneous retrieval of 7 cm long fragment of broken PICC line from abdominal IVC of a 950 g preterm baby boy born at 29 weeks of gestation. Retrieval was extremely challenging considering low weight baby managing hyper/hypothermia and radiation dose at the same time.
After informed consent, percutaneous retrieval of migrated PICC line fragment was proceeded. Under general anaesthesia and fluoroscopic guidance using aseptic measures right femoral vein was punctured and 4Fr sheath was placed. Caudal end of the broken PICC line was engaged in 3.2 F micro snare (endovascular snare system MERIT) and retrieved along with sheath.
We retrieved broken PICC fragment in a low birth weight preterm infant percutaneously from IVC using snare technique. Broken catheter fragments can be retrieved by non surgical methods using percutaneous transcatheter method especially in low birth weight critically ill infants.