• Ann Vasc Surg · May 2013

    Comparative Study

    Port-a-Cath complicated by infection or migration not removed by manual traction: usefulness of cardiac pacing leads extraction techniques.

    • Raffaele De Lucia, Luca Segreti, Ezio Soldati, Andrea Di Cori, Guilio Zucchelli, and Maria G Bongiorni.
    • Second Cardiology Division, Cardiothoracic and Vascular Department, Santa Chiara University Hospital, Pisa, Italy. raffaele_de_lucia@yahoo.it
    • Ann Vasc Surg. 2013 May 1; 27 (4): 529-36.

    BackgroundLong-term use of Port-a-Caths (PACs) is related to device-related delayed complications. The aim of this study is to describe the high success rate and safety of cardiac pacing lead extraction techniques used for PACs complicated by infection or migration and not removed by manual traction.MethodsDuring a 13-year period (1997-2010), 19 consecutive PAC recipients (54.1±13 years, 11 females) were referred to our hospital for PAC-related delayed complications and PACs not removable by manual traction (mean dwelling time 29.3±31 months).ResultsPAC implantation indications included gastrointestinal cancer (21%), breast cancer (15.7%), other malignant diseases (52.6%), and nonmalignant diseases (10.5%). PAC removal indications were breakdown due to subclavian crush (63.1%), breakdown due to unsuccessful previous removal attempt (21%), sepsis (10.5%), or malfunction (5.3%). Removal of fractured free-floating catheters (16) migrated toward the venous blood course was attempted by tool-guided traction in all cases except 1 in whom mechanical dilation was necessary. For the 3 intact ones (2 infected and one malfunctioning) we used tool-guided traction and single-sheath mechanical dilation, depending on the vascular/cardiac-catheter setting. By using multiple venous approaches we removed 18 catheters completely and 1 partially, achieving clinical success in all of the patients. The most commonly used venous approach was transfemoral (TFA; 73.6%), followed by the original venous entry site approach (VEA; 15.7%) and internal transjugular approach (ITA; 10.5%). No major or minor complications were observed.ConclusionsIn experienced centers, cardiac pacing lead extraction techniques may be considered as an additional, efficacious, safe option for extraction of otherwise nonremovable entrapped PACs before surgery.Copyright © 2013 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…