Intravascular Ultrasound-Guided Retrieval of a Radiolucent Foreign Body from the Superior Vena Cava

Interventional radiologists (IRs) are well-equipped to remove intravascular foreign bodies. The most common foreign body being removed by IRs is likely retrievable inferior vena cava (IVC) filters. The radiopaque foreign bodies like IVC filters can be differentiated from the surrounding soft tissues by fluoroscopy, making their retrieval slightly less challenging. Retained radiolucent foreign bodies are rare complications of endovascular procedures that have been sporadically reported in endovascular literature.[1] [2] [3] Diagnosis and retrieval of radiolucent foreign bodies is challenging, with unique challenges arising with different device locations. Dislodgement to the heart and lung may be considered the most dreadful complication of retained foreign bodies, particularly radiolucent objects that may remain undiagnosed. This can be complicated by cardiac arrhythmias, heart perforation, pulmonary embolization, and death.[4]

Fluoroscopy often needs to be combined with another modality to localize radiolucent foreign bodies for removal. The majority of radiolucent foreign bodies can be visualized by ultrasound, and therefore a combined ultrasound and fluoroscopy-guided retrieval can be attempted.[5] This report describes a case of retained radiolucent foreign body in the superior vena cava (SVC) removed under intravascular ultrasound (IVUS) and fluoroscopic guidance.

Publication History

Article published online:
24 January 2024

• References

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