The Removal of Intravascular Foreign Bodies by Intervention in Pediatrics

Abstract

Introduction:

The use of intravascular catheters has become increasingly widespread in children, due to their use in diagnostic procedures (such as coronary, intracardiac, cerebral, and renal angiography, as well as pressure monitoring) and for therapeutic purposes (including angioplasties, valvuloplasties, congenital defect closure, chemotherapy, among other uses). However, they are not free from complications, which may include catheter fracture and migration within the cardiovascular system, potentially leading to vascular or cavity perforation, arrhythmias, and even death.

Objective:

To define the clinical and hemodynamic characteristics of pediatric patients undergoing catheterization for the retrieval of intravascular foreign bodies.

Materials and Methods:

A retrospective cohort study of all patients under 18 years of age who underwent endovascular extraction of foreign bodies at a cardiovascular reference center.

Results:

A high percentage of successful retrieval of intravascular foreign bodies was noted, with the most frequently retrieved catheter being the chemotherapy catheter, primarily located in the right atrium, between the pulmonary trunk and the right ventricle, and in the brachiocephalic vein. Few secondary complications were observed, occurring in only 2 patients.

Conclusion:

Endovascular retrieval of foreign bodies is a highly effective procedure, and complications are relatively low in pediatrics, even during the neonatal period and in low-birth-weight cases, making it a preferable alternative to surgical extraction.

Clinical Impact

By documenting favorable outcomes across a diverse group, it encourages clinicians to adopt catheter-based approaches more confidently. The use of tools like snare loops and balloon-tipped guidewires in this population reflects procedural innovation and adaptability. Early, minimally invasive intervention may reduce morbidity and hospital stay. These findings can influence clinical decision-making and protocol development in pediatric cardiovascular care, particularly in centers equipped for interventional procedures.