Percutaneous Retrieval of a Dislodged and Migrated Port Catheter Using Ablation Catheter and Balloon Trapping Technique

Totally implantable venous access devices (TIVADs) are routinely used in oncology patients, especially those requiring long-term chemotherapy. However, they are associated with minimal complications including catheter fracture. The fundamental approach for dislodged TIVAD is via percutaneous method. Reported here is a case of a 62-year-old woman with underlying rectosigmoid carcinoma presenting with dislodged port catheter within the right atrial appendage and the distal end lodged deeply into the hepatic vein. After multiple unsuccessful attempts with pigtail catheter, conventional snaring device and home-made snare, a deflectable ablation catheter was used and successfully retracted the deeply seated port catheter into the inferior vena cava. However, difficulty was encountered retrieving the port catheter due to malalignment of the port catheter to the femoral sheath. This was overcome by balloon trapping technique which aligned the port catheter with the femoral sheath allowing it to be retrieved safely, and the patient made a full recovery without any complications from the procedure.