Balloon-Assisted Traction Removal of a Fractured Catheter in the Distal Tibial Artery.

OBJECTIVE

A patient with fractured catheter in the distal tibial artery was successfully retrieved using balloon-assisted traction.

KEY STEPS: 1) Detect the fracture and dislodgement of the catheter; 2) under fluoroscopy, identify the route of dislodgement; 3) confirming the catheter had dislodged into the right lower limb, perform arterial angiography via puncture of a contralateral artery; 4) advance a guidewire through the fractured catheter, traversing its midsection to the distal end; 5) pass 1.5-mm Maverick2 balloon over the catheter and inflate it to 16 atm; and 6) secure and carefully retrieve the catheter.

POTENTIAL PITFALLS: In high-humidity regions, the storage conditions of catheters must be strictly controlled. Moreover, the fragility of catheters should be thoroughly assessed in vitro prior to surgery to minimize the risk of vascular embolism and ischemia.

TAKE-HOME MESSAGE: Balloon capture of the fractured catheter can be considered an effective method for removing fractured catheters in the distal and small arteries.