Precise removal of fractured scalp vein catheters in infants using 3D-CT reconstruction and body surface localization: case reports and literature review

Scalp vein catheters for intravenous infusions are essential in pediatric care but carry a risk of breakage due to children’s activity. Although catheter breakage is an extremely rare complication, soft, thin catheters can become encapsulated and softened by blood vessels, potentially leading to movement, venous embolism, and significant safety risks if not promptly removed. This can also cause additional discomfort and anxiety for patients and families. Three infant cases arrived at our hospital after failed catheter fragment removals at other facilities. In Case 1, two surgeries within three days failed to extract the catheter. In Cases 2 and 3, catheters remained for 9 months and 5 years, respectively, and migrated to the neck. Prompt surgical intervention is vital for addressing broken scalp vein catheters in infants. Blind removal should be avoided to prevent unnecessary surgeries. Precise preoperative localization using a multimodal approach, primarily 3D-CT reconstruction complemented by ultrasound verification, is key to ensuring successful, minimally invasive treatment.