Images in Clinical Medicine
Embolization of the Tip of a Central Venous Catheter into the Pulmonary Artery
N Engl J Med 2005; 352:e3January 27, 2005
- Article
Video
Foreign Body in the Pulmonary Artery.
A 56-year-old man who had recently undergone coronary-artery bypass grafting and replacement of the mitral and aortic valves underwent aortobifemoral bypass surgery for Fontaine stage IIb arterial occlusive disease. The postoperative course was complicated by retroperitoneal bleeding. On day 10 after surgery, a routine chest radiograph in the intensive care unit revealed an object projecting to the left pulmonary hilus (Panel A [posteroanterior view], arrow, and Panel B [right lateral view], arrows). Thoracic computed tomography and fluoroscopy showed that the object was located in the lower left pulmonary artery (Panel C, arrow and video clip 1). The foreign body was caught with the use of a 5-French angled snare catheter and a venous transfemoral approach (Panel D [fluoroscopic anteroposterior view], arrow, and video clip 2) and was withdrawn through the right heart without complications. The 91-mm clipped tip of a triluminal central venous catheter was removed (Panel E). Accidental embolization of a fragment of a temporary central venous catheter or port catheter is a rare but potentially serious complication. Endovascular retrieval should be considered.
Andreas J. Morguet, M.D.
Heinz-Peter Schultheiss, M.D.
Charité–Campus Benjamin Franklin, 12200 Berlin, Germany
