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Rescue of a patient with a 50 cm broken PICC tube retracted and wrapped in pulmonary artery: a case report

Sha Yang
Sha Yang
, 
Ren-Tao Yu
Ren-Tao Yu
, 
Hui-Lan Zhang
Hui-Lan Zhang
, 
Xue Jiang
Xue Jiang
 y 
Jian-Ping You
Jian-Ping You
   | 30 dic 2021
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Article Category: Case report
Publicado en línea: 30 dic 2021
Páginas: 445 - 450
Recibido: 23 dic 2020
Aceptado: 18 feb 2021
DOI: https://doi.org/10.2478/fon-2021-0045
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© 2021 Sha Yang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

The method of first aid immediately after diagnostic imaging revealed that the catheter had broken off inside the body: (A) left recumbent position, hand; and (B) tourniquet ligation.
The method of first aid immediately after diagnostic imaging revealed that the catheter had broken off inside the body: (A) left recumbent position, hand; and (B) tourniquet ligation.

Figure 2

X-ray and CT scan results of the broken catheter inside the body by (A) chest positive tablets; (B) chest lateral tablets; and (C) enhanced CT, showing that the catheter was stranded in the left and right pulmonary artery trunk and branches; the ruptured catheter is indicated by an arrow.
X-ray and CT scan results of the broken catheter inside the body by (A) chest positive tablets; (B) chest lateral tablets; and (C) enhanced CT, showing that the catheter was stranded in the left and right pulmonary artery trunk and branches; the ruptured catheter is indicated by an arrow.

Figure 3

Images obtained during pulmonary artery angiography and intravascular removal of foreign matter by using (A) a pigtail catheter thread through the iliac vein, inferior vena cava, right atrium, and right ventricle pulmonary artery and (B) the guide wire wrapped around the fractured catheter; (C) shows the extraction of the fractured catheter out of the pulmonary artery and its guidance into the inferior vena cava; and as the heart contracted, the broken tube drifted into the superior vena cava and the internal jugular vein. We inserted the goose neck snare through the iliac vein, inferior vena cava, right atrium, and superior vena cava and opened the goose neck ring waiting for the exposed free fractured catheter to drift into the ring; and (D) shows the tightening of the ring, indicating it slowly being drawn through the right atrium, inferior vena cava, iliac vein, and femoral vein. Finally, the fractured catheter is successfully removed.
Images obtained during pulmonary artery angiography and intravascular removal of foreign matter by using (A) a pigtail catheter thread through the iliac vein, inferior vena cava, right atrium, and right ventricle pulmonary artery and (B) the guide wire wrapped around the fractured catheter; (C) shows the extraction of the fractured catheter out of the pulmonary artery and its guidance into the inferior vena cava; and as the heart contracted, the broken tube drifted into the superior vena cava and the internal jugular vein. We inserted the goose neck snare through the iliac vein, inferior vena cava, right atrium, and superior vena cava and opened the goose neck ring waiting for the exposed free fractured catheter to drift into the ring; and (D) shows the tightening of the ring, indicating it slowly being drawn through the right atrium, inferior vena cava, iliac vein, and femoral vein. Finally, the fractured catheter is successfully removed.

Figure 4

Images of the real broken catheter after being taken out of the body: (A) the broken catheter and (B) the length of the catheter measuring 50 cm.
Images of the real broken catheter after being taken out of the body: (A) the broken catheter and (B) the length of the catheter measuring 50 cm.

Clinical characteristics of the patient by the timeline.

Timeline Clinical characteristics
WBC, 109/L RBC, 1012/L PLT, 109/L K, mmol/L Na, mmol/L Cl, mmol/L ALT, IU/L TBIL, μmol/L Alb, g/L PT, sec APTT, sec PT-INR PTA, %
2017/9/26, before vein catheterization 3.07 2.29 33 4.01 130.9 99.1 11.0 33.12 36.40
2017/11/20, before first leaving hospital 2.58 2.55 52 2.60 143.0 103.0 9.3 16.90 38.67 14.0 45.0 1.17 70.4
2017/12/1, before catheter broken 2.23 2.12 37 2.20 142.0 102.0 14.3 42.6 1.20 67.8
2017/12/2, immediately after catheter broken 4.66 2.34 52 3.12 127.3 82.1 8.5 23.79 35.38 14.2 38.5 1.19 68.7
2017/12.18, before intervention surgery 1.99 2.04 25 4.18 137.8 109.5 14.4 14.35 39.70 14.0 40.1 1.17 70.4
2018/3/22, 3 months after surgery 2.00 3.41 24 3.70 138.6 109.8 17.0 34.40 43.90
2018/12/27, 1 year after surgery 2.77 3.95 20 3.90 109.3 109.3 24.0 38.00 43.10
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