Endovascular technique using a snare and suture for retrievi
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Chemotherapy drug administration through a peripherally inserted central catheter (PICC) has been widely used because of several advantages such as easier PICC insertion and improved patient satisfaction. The main complications of PICC are bloodstream infection and venous thrombosis, although catheter migration has been reported as a delayed complication. In cases of PICC migration to the heart or pulmonary artery, retrieval by the endovascular technique using a snare is usually attempted, but some difficulties have been reported and the procedure requires several devices and advanced techniques. We describe a patient with an ectopic PICC in the left pulmonary artery, which was successfully retrieved using a snare with a suture technique on the second attempt.

A 62-year-old male, who underwent surgeries for advanced colon cancer in November 2008 and for lung metastasis in February 2010, was receiving monthly chemotherapy through a central venous port to his right subclavian vein since March 2010. The last chemotherapy session was performed on November 22, 2010 and no problems occurred during this time. On December 20, 2010, he experienced pain in the right subclavian area during chemotherapy. Subsequent contrast-enhanced computed tomography (CT) showed an ectopic PICC in his left pulmonary artery (Figure ?(Figure1);1); therefore, the patient was presented and admitted to our hospital for retrieval of the ectopic PICC on the same day. On admission, his vital signs were stable. Blood examination showed increase in D-dimer (3.6 mg/dL) and C-reactive protein (0.96 mg/dL) levels. In addition, he had poorly controlled diabetes mellitus, with hemoglobin A1C level of 8.4%.....