PROCEDURE: 

The patient was placed supine on the angiography table and a scout radiograph of the chest was obtained. The right chest/neck was prepped and draped in sterile fashion. The right groin was also prepped and draped in sterile fashion.

The patient’s right sided chest wall port was accessed and aspiration attempted. Contrast was injected, DSA imaged obtained. A fibrin sheath noted.

The right common femoral vein was identified with ultrasound.  The overlying skin and subcutaneous tissues were infiltrated with 2% Lidocaine without epinephrine. Under ultrasound guidance, the right common femoral vein was successfully cannulated using a micropuncture needle.  An 0.018″ wire was advanced through the needle into the vein.  The needle was exchanged for a 5-F sheath. The inner obturator removed and a 0.035″ Bentson wire advanced into the IVC. The sheath removed and an 8 French long sheath advanced over the wire. The wire and inner obturator removed and an En Snare tulip snare advanced to the port catheter tip. The catheter was stripped and contrast was again injected into the port demonstrated resolution of the fibrin sheath. Blood was able to be easily aspirated from the port. At this time, the right groin sheath and catheter were removed and hemostasis achieved with pressure. Sterile dressing was applied. The port access was removed and sterile dressing applied.

The procedure was well tolerated, and the patient was discharged from the angiography suite in satisfactory condition.

 

FINDINGS: 

  1. Scout radiograph demonstrates []
  2. Mediport evaluation demonstrated a fibrin sheath on the catheter tip. Uneventful catheter stripping with good port function after procedure.

 

IMPRESSION:

1.Successful port catheter stripping with good functioning of port after procedure. Ready for use now.