1.Successful Percutaneous Transcatheter Retrieval of a Migrated Implantable Venous Port in a Patient Who Presented with Intermittent Palpitation.
Hyemoon CHUNG ; Kwangwon RHEE ; Ji Yoon HA ; Seung Kyu KIM ; Gi Young YUN ; Hyuck Moon KWON ; Byoung Kwon LEE
Korean Journal of Medicine 2013;85(2):194-198
The totally implantable venous port device is used in patients undergoing chemotherapy. The complications associated with this device include venous thrombosis, infection, catheter fracture, extravasation, and intravascular dislodgement. The incidence of port catheter dislodgement is low. The treatment of choice for port dislocation involves immediate retrieval of the distal migrated part, and percutaneous transcatheter retrieval is regarded as the standard method. A 40-year-old female presented with intermittent palpitation. She was referred from the Department of General Surgery after detection of a fractured and dislocated implantable venous port system into the main pulmonary artery. We successfully retrieved the dislocated fractured device using a 5-Fr pigtail catheter and snare catheter. We herein report this case with a literature review.
Cardiac Complexes, Premature
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Catheterization, Central Venous
;
Catheters
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Catheters, Indwelling
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Dislocations
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Female
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Humans
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Incidence
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Pulmonary Artery
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SNARE Proteins
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Vascular Access Devices
;
Venous Thrombosis
2.The Significance on the Retrograde Pericatheter Urethrography in the Timing of the Removal of Indwelling Uretbral Catheter.
Su Cheon LEE ; Seok San PARK ; Hee Seok CHOI
Korean Journal of Urology 1995;36(11):1255-1259
Whether indwelling urethral catheter should be removed after urethroplasty or visual internal urethrotomy in patients with posterior urethral injured is still controversial. From May 1990 to February 1995, 28 patients with posterior urethral injury underwent retrograde pericatheter urethrography for the purpose of the evaluation of urethral continuity in the timing of the removal of indwelling urethral catheter. The indwelling catheter was removed in 24 patients whose urethra did not have any extravasation, and 4 patients had detectable extravasation. We conclude that retrograde pericatheter urethrogram is the most useful radiologically diagnostic method to evaluate in the timing of the removal of indwelling urethral catheter and to obtain the objective parameter of urethral patency in posterior urethral injured patients, postoperatively.
Catheters*
;
Catheters, Indwelling
;
Humans
;
Urethra
;
Urinary Catheters
3.Radiologic Interventional Retrieval of Retained Central Venous Catheter Fragment in Prematurity: Case Report.
Jee Won PARK ; Jung Hyun JO ; Byeong Ho PARK
Journal of the Korean Radiological Society 2007;57(6):519-523
The fracture of a central venous catheter is a rare but potentially serious complication. Moreover, removal of the broken catheter pieces is considerably challenging, especially for premature infants. We report 3 case studies of the percutaneous transcatheter retrieval of broken catheter parts in 3 premature infants. We confirmed the location of the catheter fragments via a DSA venogram with diluted contrast media. Using the minimum amount of contrast, and extreme caution, we made certain no contrast-induced nephrotoxicity or air embolism occured during catheter manipulation. In addition, when the broken fragment was curled or attached to the cardiac wall, we used a hook-shaped catheter to facilitate the capturing of the catheter with a loopsnare. This report demonstrates the feasibility of removing a retained catheter fragment in a premature infant using a percutaneous transcatheter approach.
Catheter Ablation
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Catheterization, Central Venous
;
Catheters
;
Catheters, Indwelling
;
Central Venous Catheters*
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Contrast Media
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Embolism, Air
;
Equipment Failure
;
Humans
;
Infant, Newborn
;
Infant, Premature
4.Catheter Obstruction of Intrathecal Drug Administration System: A Case Report.
Seok Myeon RHEE ; Eun Joo CHOI ; Pyung Bok LEE ; Francis Sahngun NAHM
The Korean Journal of Pain 2012;25(1):47-51
Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.
Adult
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Analgesics, Opioid
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Catheter Obstruction
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Catheters
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Catheters, Indwelling
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Failed Back Surgery Syndrome
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Humans
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Infusion Pumps, Implantable
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Injections, Spinal
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Morphine
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Pain, Intractable
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Stress, Psychological
5.The placement of an Implantable Chemoport via the External Jugular Vein as a Primary Route.
Moonsang AHN ; Byung Seok SHIN ; Mi Hyun PARK
Journal of the Korean Radiological Society 2008;58(3):237-242
PURPOSE: To evaluate the usefulness and safety of the placement of an implantable chemoport via external jugular vein as a primary route for chemotherapy. MATERIALS AND METHODS: Between January 2006 and June 2007, a total of 108 implantable chemoports were placed on 325 patients for chemotherapy via the external jugular vein as a primary route. We placed a 9.6 F single lumen chemoport using a surgical procedure (n=89) and an interventional procedure (n=19), and evaluated the duration of catheterization days and treatment complications. RESULTS: An implantable chemoport was successfully installed in all cases. Furthermore, the duration of catheterization ranged from 2 to 461 days (mean: 187 days, total catheter days: 21,994). In addition, a total of 85 chemoports were removed due to complications (n=7) and termination of chemotherapy (n=78). A transient pulmonary air embolism occurring during a procedure was observed in one case. No pneumothorax or catheter malpositions were observed in the study subjects. Two chemoports were removed two days after implantation due to persistent tachycardia. In addition, five late complications occurred, which resulted in catheter occlusion (3 cases) (3%, 0.14/1000 catheter day) and infection in (2 cases) (2%, 0.09/1000 Catheter days). Lastly, no symptoms were attributed to a central vein thrombosis. CONCLUSION: The results of this study suggest that the implantation of chemoports via the external jugular vein is a safe procedure. Moreover, the selection of the external jugular vein as a primary route is useful in determining chemoport insertion locations.
Catheterization
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Catheterization, Central Venous
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Catheters
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Catheters, Indwelling
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Embolism, Air
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Humans
;
Jugular Veins
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Pneumothorax
;
Tachycardia
;
Thrombosis
;
Veins
6.Analysis of the Outcome of Tunneled Hemodialysis Catheters in Children according to the Indications for Use.
Eung Jik LEE ; Suk Bae MOON ; Sung Eun JUNG ; Seong Cheol LEE ; Jongwon HA ; Kwi Won PARK
Journal of the Korean Society for Vascular Surgery 2007;23(2):181-186
PURPOSE: The tunneled hemodialysis catheter has been widely used for a temporary or an alternative permanent vascular access in patients requiring hemodialysis. The tunneled hemodialysis catheter is also widely used for a reliable vascular access in children who need stem cell transplantation. METHOD: We reviewed the results of 150 catheters inserted in 108 patients for the duration of the indwelling catheter, the complication rate and the reasons for insertion and removal. RESULT: The mean duration of the indwelling catheter was 5.7 months (1 d~52.2 mo). In the stem cell transplantation group, the mean duration of the indwelling catheter was significantly longer than for the hemodialysis group (mean: 9.9 mo vs. 3.6 mo, P<0.05). Fifty-one catheters (39.8%) were removed due to complications. The most common complications were infection (n=23: 17.9%) and dislocation (n=15: 11.7%). In the hemodialysis group, the complication-related catheter removal was more frequent than in the stem cell transplantation group (43.9% vs. 32.6%, P<0.05). CONCLUSION: The tunneled hemodialysis catheter remains a reliable short-term vascular access for hemodialysis and a good vascular access in stem cell transplantation.
Catheterization, Central Venous
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Catheters*
;
Catheters, Indwelling
;
Child*
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Dislocations
;
Humans
;
Renal Dialysis*
;
Stem Cell Transplantation
8.Two-Year Hospital-Wide Surveillance of Central Line-Associated Bloodstream Infections in a Korean Hospital.
Hye Kyung SEO ; Joo Hee HWANG ; Myoung Jin SHIN ; Su young KIM ; Kyoung Ho SONG ; Eu Suk KIM ; Hong Bin KIM
Journal of Korean Medical Science 2018;33(45):e280-
BACKGROUND: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. METHODS: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). RESULTS: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Non-tunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. CONCLUSION: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.
Catheters
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Catheters, Indwelling
;
Central Venous Catheters
;
Hand
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Hospitals, Teaching
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Humans
;
Intensive Care Units
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Korea
;
Patients' Rooms
;
Tertiary Healthcare
9.A Clinical Analysis of the Ventriculoatrial Shunts in Hydrocephalus.
Duk Yong KIM ; Hae Dong JHO ; Yung Rak YOO ; Nam Kyu KIM ; Hwan Yung CHUNG
Journal of Korean Neurosurgical Society 1980;9(2):587-594
The ventriculoatial shunt consists of diverting the cerebrospinal fluid from one lateral ventricle to the right atrium of the heart by means of a subcutaneous valve regulated drainage system. Of the numerous drainage systems so far devised, two, Holter and Pudenz, can be cited as having received widespread acceptance. This study is a clinical investigation of the 18 cases of ventriculoatrial shunts performed at Hanyang University Hospital between May 1972 and December 1978. Of them 17 cases and the Holter System, and one the Pudenz System. Ventricular catheter tip was placed in the frontal horn and cardiac catheter tip in the upper margin of the 6th thoracic vertebra. Postoperatively immediate neurological improvement usually took place in most instances. However, four complications developed. One of them was ventricular catheter obstruction with small brain tissue particles which was removed by revision. The other ventricular catheter obstruction was the result of thickening of the cerebral mantle and reduction in size of the ventricle. This shunt was made patient again byshortening the ventricular catheter to place inside the shrunk ventricle. The third was shunt infection. In this case, the whole shunting system was removed and reapplied into a peritoneal route, after infection subsided. The last was postoperative epidural hematoma developed due to incomplete hemostasis which required emergency surgery. Shunt obstruction was said as an inevitable complication in many instances, but it may easily restored by revision. Shunt infection was also surgically amenable. Although the necessity of revision was inevitable in some instances, ventriculoatrial shunt still seemed to be the most effective method so far devised.
Animals
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Brain
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Cardiac Catheters
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Catheter Obstruction
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Catheters
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Cerebrospinal Fluid
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Drainage
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Emergencies
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Heart
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Heart Atria
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Hematoma
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Hemostasis
;
Horns
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Humans
;
Hydrocephalus*
;
Lateral Ventricles
;
Spine
10.A Clinical Observation on Retropubic Combined Prostatectomy.
Korean Journal of Urology 1979;20(3):289-294
A clinical study was made on 11 cases of Benign Prostatic Hypertrophy and 2 cases of Prostatic Carcinoma that had Retropubic combined Prostatectomy. admitted to the Department of Urology, Jeonbug National University Medical School during the Period from Aug. 1977 to Aug. 1978. The results are summarized as follows ; 1. Incidence of Benign Prostatic Hypertrophy was 5.4 % to 204 total in-patients, and 28.6 % to male in-patients 60 years old or more and incidence of prostatic carcinoma was 0.95 % to 204 total in-patients and 5.3 % to male in-patients 60 years old or more 2. The age distribution ranged from 62 years to 76 years with the most common age groups in the 7th and 8th decades with mean age 70.1 years old. 3. The most common symptoms are urinary retention, dribbling and dysuria. 4. The duration of symptoms ranged from 1 day to 4 months with mean 20.7 days. 5. The coexisting diseases were left hydrocele in 1 case and asthma in 1 case. 6. E. C. G. findings were L. V. H. In 1 case, arrhythmia in 1 case but normal in 11 cases. 7. Serum B. U. N. and creatinine determinations were done in all cases, 4 patients had elevated serum B. U. N. and 1 patient had elevated serum creatinine. 8. Methods of operative treatment included Retropubic combined Prostatectomy in all cases. 9. Visual bleeding control is done in all cases. 10. Operating time required between 70 minutes and 110 minutes with mean operating time 85 minutes. 11. Blood attributable to operating manipulation was between 200ml to 1,000ml with mean blood loss was 375ml. 12. Duration of indwelling catheterization was 8.5 days. 13. The duration of gross hematuria persisted postoperatively was between 2 days and 4 days, 2.5 days in average. 14. Weight of removed prostatic tissue was between 7 gms to 100 gms, mean weight was 28.0 gms. 15. Postoperative Hospitalization was between 7 days and 9days, 7.9 days in average. 16. No severe complications other than temporary Incontinence in 5 cases(38.5 %) and acute Epididymitis in 1 case.
Age Distribution
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Arrhythmias, Cardiac
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Asthma
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Catheters, Indwelling
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Creatinine
;
Dysuria
;
Epididymitis
;
Hematuria
;
Hemorrhage
;
Hospitalization
;
Humans
;
Incidence
;
Jeollabuk-do
;
Male
;
Middle Aged
;
Prostatectomy*
;
Prostatic Hyperplasia
;
Schools, Medical
;
Urinary Retention
;
Urology