Abstract
A 68-year-old female on chronic hemodialysis therapy for 20 years was admitted with an intravascular foreign body, a migrating broken plastic catheter for dialysis-access, in December 1990. The dialysis-access, a brachiocephalic fistula, is usually inserted by puncture with an ordinary plastic catheter in the left antecubital fossa. Migration of the broken tip was recognized because of hemorrhage from the puncture site. The proximal portion of the access was compressed to avoid central migration. The migrated radiolucent catheter was not localized by palpation or a portable X-ray film, but by high-resolution ultrasonography with a 7.5MHz probe. The catheter was easily removed under local anesthesia. The broken tip of the catheter had pulled away from the underlying structure, but had not been cut by the needle within the catheter during the procedure. The cause of the breakdown seemed to be a manufacturing defect in the catheter. Ultrasound was very effective in localizing the intravascular radiolucent foreign body. No other case reports of a migrating broken plastic catheter for dialysis-access could be found in the literature.
