RESUMO
The recent increase in the number of patients with implanted peripherally inserted central catheters (PICCs) requires physicians to be familiar with rare and unusual complication-pinch-off syndrome (POS). We present a case of a 40-years-old female with human epidermal growth factor receptor type 2 (HER2)-positive breast cancer and implanted Groshong PICC (BARD). The patient was admitted for an elective chest and abdomen CT angiography control after finishing her trastuzumab and paclitaxel chemotherapy course a month earlier. Immediately after the contrast media power injection, the PICC line was embolized to the right segmental pulmonary artery. Due to the low complications rate and early patient ambulation percutaneous foreign body retrieval is a primary option for the pinch-off syndrome, especially in frail, and vulnerable cancer patients. This case underscores the feasibility and safety of percutaneous venous interventions in patients with embolized venous infusion devices.
RESUMO
Advanced endovascular technology and techniques allow interventional radiologists to utilize novel ways of basilar artery recanalization in the setting of acute ischemic stroke, especially when routine approaches are not eligible. Several authors described nonstandard revascularization techniques in acute ischemic strokes due to basilar and middle cerebral arteries occlusions with full technical and clinical success. In this report, we present retrograde right vertebral artery recanalization using left posterior communicating artery for subsequent anterograde balloon angioplasty and stenting of a right vertebral artery ostium followed by full vertebrobasilar blood flow restoration. The case underscores the complexity of arterial thrombotic events, the beneficial role of endovascular intervention in vertebral occlusions and the necessity of prospective studies that identify optimal methods of treating vertebrobasilar stroke due to large vessel occlusions and their effectiveness and safety.