PMC4752695_01
A, Angiographic View of the Saphenous Vein Graft Lesions at the Ostial and Mid Portion; B, Successful Stenting of the Saphenous Graft Lesions
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The lesions were pre-dilated with 2.5 x 20 mm balloons (Sprinter Legend, Medtronic, USA), followed by implantation of a 3.0 x 28 mm Xience Pro stent (Abbott Vascular, USA) at 14 atm for the mid lesion and a 3.0 x 18 mm Xience Pro stent (Abbott Vascular, USA) at 16 atm for the ostial lesion (Figure 1A and B).
A, Yellow Arrow, Fluoroscopic Appearance of the Embolized Catheter Tip Found at the Left Ankle Level; Red Arrow, Hydrophilic Guidewire Near the Embolized Catheter; B, Yellow Arrow, Catheter Fragment; Red Arrow, Guidewire; Blue Arrow, Single Marker of the 1.0 x 10 mm Balloon Before Advancing into the Catheter Fragment; Green Arrow, 5f JR Diagnostic Catheter.
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We introduced a 5f JR diagnostic catheter beyond the popliteal artery, and used the hydrophilic wire to cross the lumen of the longitudinally-oriented catheter fragment, which had a lumen of 4f and a length of 2 cm (Figure 2A). Over the wire, a small-sized balloon (1.0 x 10 mm, Sprinter Legend, Medtronic, USA) was advanced inside the lumen of the catheter fragment and inflated at 10 atm of pressure to ensure that the balloon tightly held the inner wall of the catheter (Figure 2B).
Fluoroscopic Views Showing the Successful Retrieval Through the Femoral Sheath of the Catheter Tip as a Whole Unit With the Diagnostic Catheter, Inflated Balloon, and Guidewire. A, Passing through the popliteal level; B, Entrance into the femoral sheath.
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The catheter fragment was seen to be tightly held by the inflated balloon, and it was moved together with the system and successfully retrieved out of the circulation via the femoral sheath (Figure 3A and B).
Catheter Fragment After Removal
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The broken catheter tip after removal is demonstrated in Figure 4A and B.