Percutaneous retrieval of dislodged central venous port catheter: experience of 25 patients in a single institute.

ABSTRACT

BACKGROUND: For a dislodged port catheter, percutaneous retrieval by using a loop snare or a basket is the standard technique, with high success. However, once a loop snare fails, the likelihood of success with other tools is considered low. PURPOSE: To report our experience of percutaneous retrieval of dislodged port catheters and to emphasize the usefulness of grasping forceps. MATERIAL AND METHODS: During a 6-year period, a total of 25 dislodged port catheters were retrieved in our institute. The interval between port catheter implantation and dislodged catheter retrieval was 3-85 months (mean 23 months). The time of delayed retrieval ranged from 3 to 604 days (mean 58 days). A loop snare or grasping forceps were used via either the femoral or jugular route. RESULTS: The prevalence of port catheter dislodgement was 0.4% in our institute. All dislodged port catheters were successfully removed, including four patients with delayed retrieval of more than 90 days. A loop snare was used in 20 patients, with technical success in 18. Grasping forceps were used in seven patients, all with success (including the two patients who failed by initial use of a loop snare). No procedure-related complications were encountered, except transient arrhythmia in four patients requiring no medication. CONCLUSION: Although the prevalence of port catheter dislodgement is low, percutaneous attempts at retrieval should be performed in all patients, even in chronic settings. A loop snare is the instrument of choice for retrieval. Grasping forceps can be used as an auxiliary instrument, especially in patients where a loop snare fails.