Delayed retrieval of a fractured radial artery catheter in a critically ill patient

Radial artery catheters are commonly used for invasive blood pressure monitoring. Catheter fragmentation has been described; however, there are no guidelines on the appropriate timeline for intervention in the absence of limb-threatening symptoms. A 77-year-old female was admitted to the intensive care unit in septic shock secondary to pneumonia. During hospitalization, she tried to pull out her arterial line, resulting in a fragmented and retained radial artery catheter. To allow for treatment of her septic shock, catheter retrieval was delayed for 72 hours, and the patient was placed on a heparin drip. Intraoperative ultrasound and Fogarty balloon retrieval were utilized, avoiding additional arteriotomy when the catheter migrated proximally.