Percutaneous Endovascular Retrieval of an Embolized Fractured Port-a-Cath Catheter in a 3-Year-Old Child: A Case Report
Nafii Omar
*
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Anass M’ghari
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Mohamed Sarsari
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Soukaina Cherkaoui
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Kerrouani Oualid
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Jamila Zarzur
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
Cherti Mohamed
Department of Cardiology B, Faculty of Medicine and Pharmacy, CHU Ibn Sina, Mohammed V University, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Implanted central venous access devices are widely used in paediatric oncology patients for the administration of chemotherapy and supportive treatments. Although considered safe, catheter fracture with intravascular migration remains an uncommon but potentially serious complication that requires urgent intervention. We report a case of successful percutaneous retrieval of a migrated port catheter fragment in a child.
Case Presentation: A 3-year-old girl was referred for intravascular migration of a fractured port catheter extending into the superior vena cava and right atrium. In the catheterisation laboratory, under general anaesthesia, a 6-French sheath was introduced through the right femoral vein. Endovascular retrieval was subsequently achieved using a 10 mm Amplatz GooseNeck snare. The embolised fragment was successfully snared, aligned, and removed safely without any procedural complications.
Conclusion: Catheter embolisation secondary to the fracture of an implanted venous access device is a rare but critical complication, particularly in paediatric patients. This case demonstrates that even with a technically challenging, U-shaped intracardiac configuration in a very young child, percutaneous retrieval using a gooseneck snare is a safe, effective, and minimally invasive strategy that averts the need for surgical intervention. This procedural strategy offers educational value for multidisciplinary clinicians managing intravascular foreign bodies in children.
Keywords: Paediatric oncology, Port-a-Cath, central venous access device, catheter fracture, catheter embolisation, intracardiac migration, endovascular retrieval, gooseneck snare, fluoroscopy, femoral venous access