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Endovascular Retrieval of Intracaval Cement: A Fishing Net Technique

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Abstract

Purpose

To describe a novel endovascular technique for intracaval cement retrieval after spinal surgery.

Technique

We produced a replica of the intracaval cement fragment and a 3D print to plan the endovascular procedure. A woven caval filter was modified with two drawstring sutures to be used as fishing net. We used a 10F sheath in the right internal jugular vein to place the caval filter proximal to the floating fragment, and a 24F sheath in the right femoral vein was the working access. After the deployment of the caval filter, the following steps were performed through the 24F sheath: (A) The drawstring sutures were snared and retrieved to the skin surface in the groin; (B) the fragment was secured with two snare catheters from the femoral access and one through the lumen of the caval filter; (C) the fragment was broken off with a snared guide wire at the base; (D) the smallest fragment was removed directly with the snare; (E) the larger dislodged fragment was controlled within the periprocedural caval filter by tightening the drawstring and removed through the 24F sheath.

Conclusion

Cement fragments located in the inferior vena cava after cement-augmented spinal surgery procedures can be safely removed by the described fishing net technique.

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Author information

Author notes

  1. Andrej Isaak and Martin Takes have equally contributed to this work.

Authors and Affiliations

  1. Department of Vascular and Endovascular Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland

    Andrej Isaak & Lorenz Gürke

  2. Department of Interventional Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Martin Takes

  3. Department of Vascular and Endovascular Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF, UK

    David Kingsmore

Authors
  1. Andrej Isaak
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  2. Martin Takes
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  3. David Kingsmore
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  4. Lorenz Gürke
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Corresponding author

Correspondence to Andrej Isaak.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was obtained from the Ethikkommission Nordwest-und Zentralschweiz (EKNZ, Basel, Switzerland).

Human and Animals Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for every individual person’s data included in the study.

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Isaak, A., Takes, M., Kingsmore, D. et al. Endovascular Retrieval of Intracaval Cement: A Fishing Net Technique. Cardiovasc Intervent Radiol 41, 1958–1961 (2018). https://doi.org/10.1007/s00270-018-2061-6

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  • DOI: https://doi.org/10.1007/s00270-018-2061-6

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