Key result
Percutaneous snare technique for removing catheter emboli has minimal morbidity and a high success rate when performed by skilled operators.
Percutaneous snare techniques via the femoral vein are the preferred, low-morbidity approach for retrieving catheter emboli from the right heart and pulmonary artery.
Supports snare use by skilled operators for embolus retrieval; leaves open need for prospective validation.
ventricle and pulmonary artery.Half of all emboli to the right ventricle cause a major complication or death.4Before 1970 embolic fragments were either left or removed at thorocotomy.Various less invasive techniques have been employed using snares, hooks, forceps, and ureteric stone baskets.2-5The percutaneous snare technique is widely practised and has minimal morbidity and a high success rate in the hands of a skilled cardiac catheteriser.The femoral vein approach is preferred, as a formal cutdown is not necessary and the risk of dislodgment of the proximal end of the catheter is less than when an antecubital or neck vein approach is used.Catheter fragments in the pulmonary artery may necessitate a longer catheter or an approach from an antecubital or neck vein.3Catheter emboli should be removed as soon as possible by skilled operators and, when transvenous methods fail, direct operative intervention is advised, provided the patient's condition will tolerate it.If the infraclavicular subclavian vein is used the catheter should be inserted through a polyethylene introducer and not a metal needle.
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Tcherdakoff et al. (1978) conducted a review in Catheter emboli in the right ventricle and pulmonary artery. Percutaneous snare technique was evaluated. Percutaneous snare technique for removing catheter emboli has minimal morbidity and a high success rate when performed by skilled operators.