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Retained Endoscope: An Unexpected but Serious Complication of Hemospray®

Yii RSL, Chuah KH, Poh KS, Lau PC, Ng KL, Ho SH, et al.

Dig Dis Sci, 2022 01;67(1):344-347.
PMID: 33491164 DOI: 10.1007/s10620-021-06835-4
Matched MeSH terms: Device Removal/methods*
Fulltext Infective endocarditis and the pacemaker: cardiac implantable electronic device infection

Yew KL

Med J Malaysia, 2012 Dec;67(6):618-9.
PMID: 23770958 MyJurnal

We are seeing more implantation of cardiac device such as pacemakers and defibrillators and also cardiac implantable electronic device infection. The infection may affect just the pocket site or progress to deeper infection and bacteraemia. Inadequately treated infection may lead to right sided endocarditis, cardiotomy for pacemaker explantation and increased cost and length of stay in the hospital. We report a Staphylococcal infection of a pacemaker system, its successful medical and surgical management.

Matched MeSH terms: Device Removal
Retained haemodialysis-catheter guidewire in the head and neck: a multidisciplinary team approach

Xiao Hong C, Abd Wahab S, Azman M

BMJ Case Rep, 2020 Oct 27;13(10).
PMID: 33109696 DOI: 10.1136/bcr-2020-236484

Penetrating foreign body in the head and neck can be catastrophic from injury to the constellation of vascular and neural structures in the neck. Early recognition and prompt surgical intervention is imperative to save lives. Herein, we present an unusual case of iatrogenic foreign body-a coiled guidewire embedded in the deep neck space. The complications, radiological investigation and multidisciplinary surgical management are further discussed.

Matched MeSH terms: Device Removal/methods
Impact of interventional nephrology on outcome and penetration rate of a CAPD program

Wong CM, Ng KP, Keng TC, Lim SK, Tan SY

Perit Dial Int, 2011 3 24;31(2):194-6.
PMID: 21427247 DOI: 10.3747/pdi.2009.00237
Matched MeSH terms: Device Removal/statistics & numerical data
Fulltext "Fishing for lines": removal of endovascular catheters from the cardiovascular system

Wong AR, Suhaimi H, Ridzuan MA, Rizal MM, Saedah A

Singapore Med J, 2009 Oct;50(10):e358-61.
PMID: 19907875

We present two infants whose endovascular lines were accidentally cut or fractured, and had to be retrieved via transcatheter means in the cardiac catheterisation laboratory. The first case was a two-month-old infant with transposition of the great arteries, requiring an emergency balloon atrial septostomy. An indwelling vascular catheter that was placed in the right femoral vein was accidentally cut and had migrated into the inferior vena cava, before being retrieved. The second case was a one-week-old neonate who presented with pneumonia at birth, and had a long intravenous catheter placed in the left saphenous vein, which became fractured, and subsequently migrated into the heart. This case presented as a pulmonary embolus with haemodynamic instability, as the catheter had partially obstructed the right ventricular outflow tract. This was later retrieved via transcatheter means.

Matched MeSH terms: Device Removal*
Comparison between the use of LMA™ and SLIPA™ in patients undergoing minor surgeries

Wan Rahiza, W.M., Nurlia, Y., Abd Rahman, I., Esa, K., Nadia, M.N., Raha, A. R.

Journal of Surgical Academia, 2012;2(1):8-13.
MyJurnal

Supraglottic airway devices have been used as safe alternatives to endotracheal intubation in appropriate types of surgery. This was a prospective, randomised, single blind study comparing the use of LMA™ and SLIPA™ in terms of ease of insertion, haemodynamic changes and occurrence of adverse effects (e.g. blood stains on the device upon removal and sore throat). A total of 62 ASA I or II patients, aged between 18 to 70 years were recruited for this study. Patients were randomised into two groups; LMA™ and SLIPA™ group. Following induction of anaesthesia, an appropriate sized LMA™ or SLIPA™ was inserted after ensuring adequate depth of anaesthesia. Anaesthesia was maintained with oxygen, nitrous oxide and sevoflurane. The ease of insertion was graded and haemodynamic changes were recorded at 2 minute intervals up to 10 minutes after insertion of the airway devices. The presence of blood stains upon airway device removal at the end of surgery and incidence of sore throat was also recorded. No difficult insertion was experienced in either of these devices. Insertion was either easy [LMA™ 87.1% versus SLIPA™ 80.6% (p = 0.49)] or moderate [LMA™ 12.9% versus SLIPA™ 19.4% (p = 0.16)]. Throughout the study period, the haemodynamic changes that occurred in both groups were not statistically different. Traces of blood were noted on the surface of the device in 9.7% of patients in the SLIPA™ group versus 6.5% of patients in the LMA™ group. The incidence of sore throat was recorded in 12.9% versus 19.4% of patients in the SLIPA™ and the LMA™ groups respectively. These findings were not statistically significant. In conclusion, this study showed no significant differences between the use of LMA™ and SLIPA™ in terms of ease of insertion, haemodynamic changes and adverse effects in patients undergoing minor surgical procedures.

Matched MeSH terms: Device Removal
Placement of removable metal biliary stent in post-orthotopic liver transplantation anastomotic stricture

Tee HP, James MW, Kaffes AJ

World J Gastroenterol, 2010 Jul 28;16(28):3597-600.
PMID: 20653071

Postoperative biliary strictures are the most common cause of benign biliary stricture in Western countries, secondary to either operative injury or bile duct anastomotic stricture following orthotopic liver transplantation (OLT). Surgery or endoscopic interventions are the mainstay of treatment for benign biliary strictures. We aim to report the outcome of 2 patients with refractory anastomotic biliary stricture post-OLT, who had successful temporary placement of a prototype removable covered self-expandable metal stent (RCSEMS). These 2 patients (both men, aged 44 and 53 years) were given temporary placement of a prototype RCSEMS (8.5 Fr gauge delivery system, 8 mm x 40 mm stent dimensions) in the common bile duct across the biliary stricture. There was no morbidity associated with stent placement and removal in these 2 cases. Clinical parameters improved after the RCSEMS placement. Long-term biliary patency was achieved in both the patients. No further biliary intervention was required within 14 and 18 mo follow-up after stent removal.

Matched MeSH terms: Device Removal
Fulltext Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial

Tan PC, Mackeen A, Khong SY, Omar SZ, Noor Azmi MA

Sci Rep, 2016 Mar 18;6:23223.
PMID: 26987593 DOI: 10.1038/srep23223

A peripheral intravenous catheter is often inserted as part of care during labour. The catheter is inserted into the back of the hand or lower forearm vein in usual practice. There is no trial data to guide the care provider on which is the better insertion site in any clinical setting. 307 women admitted to the labour ward who required insertion of intravenous catheter were randomised to back of hand or lower forearm vein catheter insertion. Catheter insertion is by junior to mid-grade providers. We evaluated insertion success at the first attempt, pain during insertion and catheter replacement due to malfunction as main outcomes. After catheter removal, we recorded patient satisfaction with site, future site preference and insertion site swelling, bruising, tenderness, vein thrombosis and pain. Insertion of a catheter into back of hand vein is more likely to be successful at the first attempt. Insertion pain score, catheter replacement rate, patient satisfaction, patient fidelity to site in a future insertion and insertion site complications rate are not different between trial arms. In conclusion, both insertion sites are suitable; the back of the hand vein maybe easier to cannulate and seems to be preferred by our frontline providers.

Matched MeSH terms: Device Removal
Tracheostomy decannulation readiness: A cross sectional study comparing standardised evaluation for tacheostomy decannulation to flexible endoscopic evaluation of swallowing examination

Tamin S, Shabrina F, Hutauruk SM, Rachmawati EZK, Fardizza F, Koento T, et al.

Med J Malaysia, 2024 Mar;79(2):119-123.
PMID: 38553913

INTRODUCTION: Tracheostomy is a procedure commonly performed in neurocritical and mechanically ventilated patients in the intensive care unit. Dysphagia and impaired airway protection are the main causes for a delay in tracheostomy decannulation in patients with neurological disorders. Endoscopic evaluation is an objective examination of readiness for tracheostomy decannulation with flexible endoscopic evaluation of swallowing (FEES) as the most commonly used method, yet it requires special expertise and is heavily dependent on its operator in assessing the parameters. A relatively new method for assessing decannulation readiness in neurologic disorder, the Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation (SESETD) was introduced in 2013 by Warnecke, et al. This method includes stepwise evaluation of secretion management, spontaneous swallowing and laryngeal sensitivity. This study aims to find conformity between the SESETD and FEES in assessing readiness for tracheostomy decannulation in patients with neurologic disorders.
MATERIALS AND METHODS: This study is a cross-sectional study conducted on 36 neurologic patients at Cipto Mangunkusumo General Hospital which was aimed to find the agreement between two modalities for tracheostomy decannulation readiness, FEES and SESETD based on parameters, standing secretion, spontaneous swallowing and laryngeal sensitivity.
RESULT: A total of 36 subjects were examined and 22 of them underwent successful tracheostomy decannulation. The agreement between FEES and SESETD showed significant results with p-value <0.0001 and Kappa value = 0.47.
CONCLUSION: There was conformity between FEES and SESETD in evaluating tracheostomy decannulation readiness based on three parameters: standing secretion, spontaneous swallowing and laryngeal sensitivity.

Matched MeSH terms: Device Removal/methods
A simple method for removal of a broken intramedullary nail

Sivananthan KS, Raveendran K, Kumar T, Sivananthan S

Injury, 2000 Jul;31(6):433-4.
PMID: 10831741

The removal of broken implanted intramedullary nails secondary to re-fracture or non-union is challenging. In 12 cases a simple and safe method has been used to remove broken implants.

Matched MeSH terms: Device Removal/methods*
Fulltext eComment: Trans-pericardial extra-anatomic aortic bypass for coarctation of the aorta

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 Jul;13(1):100.
PMID: 21697404 DOI: 10.1510/icvts.2010.265264A
Matched MeSH terms: Device Removal*
Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)-non-inferiority (peripheral arterial catheter) trial

Rickard CM, Marsh NM, Larsen EN, McGrail MR, Graves N, Runnegar N, et al.

Lancet, 2021 04 17;397(10283):1447-1458.
PMID: 33865494 DOI: 10.1016/S0140-6736(21)00351-2

BACKGROUND: The optimal duration of infusion set use to prevent life-threatening catheter-related bloodstream infection (CRBSI) is unclear. We aimed to compare the effectiveness and costs of 7-day (intervention) versus 4-day (control) infusion set replacement to prevent CRBSI in patients with central venous access devices (tunnelled cuffed, non-tunnelled, peripherally inserted, and totally implanted) and peripheral arterial catheters.
METHODS: We did a randomised, controlled, assessor-masked trial at ten Australian hospitals. Our hypothesis was CRBSI equivalence for central venous access devices and non-inferiority for peripheral arterial catheters (both 2% margin). Adults and children with expected greater than 24 h central venous access device-peripheral arterial catheter use were randomly assigned (1:1; stratified by hospital, catheter type, and intensive care unit or ward) by a centralised, web-based service (concealed before allocation) to infusion set replacement every 7 days, or 4 days. This included crystalloids, non-lipid parenteral nutrition, and medication infusions. Patients and clinicians were not masked, but the primary outcome (CRBSI) was adjudicated by masked infectious diseases physicians. The analysis was modified intention to treat (mITT). This study is registered with the Australian New Zealand Clinical Trials Registry ACTRN12610000505000 and is complete.
FINDINGS: Between May 30, 2011, and Dec, 9, 2016, from 6007 patients assessed, we assigned 2944 patients to 7-day (n=1463) or 4-day (n=1481) infusion set replacement, with 2941 in the mITT analysis. For central venous access devices, 20 (1·78%) of 1124 patients (7-day group) and 16 (1·46%) of 1097 patients (4-day group) had CRBSI (absolute risk difference [ARD] 0·32%, 95% CI -0·73 to 1·37). For peripheral arterial catheters, one (0·28%) of 357 patients in the 7-day group and none of 363 patients in the 4-day group had CRBSI (ARD 0·28%, -0·27% to 0·83%). There were no treatment-related adverse events.
INTERPRETATION: Infusion set use can be safely extended to 7 days with resultant cost and workload reductions.
FUNDING: Australian National Health and Medical Research Council.

Matched MeSH terms: Device Removal/economics
Iatrogenic displacement of high-speed bur during third molar removal

Rajaran JR, Nazimi AJ, Rajandram RK

BMJ Case Rep, 2017 Sep 27;2017.
PMID: 28954756 DOI: 10.1136/bcr-2017-221892

Surgical removal of impacted mandibular third molar is a routine procedure in oral surgery. Various iatrogenic complications related to the procedure has been discussed well in the literatures before. Some of these complications are related to the wrong usage of instruments and techniques. Here we discuss a rare complication on a 42-year-old male, related to the use of high-speed handpiece drill in mandibular third molar removal in a general dental office setting. He was referred when a high speed tungsten carbide bur was accidentally broken and displaced into the mandibular bone during surgical procedure. It is not common to use a high-speed handpiece in impacted third molar removal. This iatrogenic complication could have been totally avoided with the use of proper equipment and technique; therefore raising awareness regarding wrong usage of instrument is vital to avoid similar incidents in the future.

Matched MeSH terms: Device Removal
Fulltext Removal of failed dental implant with application of concentrated growth factor (CGF): a case report

Nurul Ain Mohamed Yusof, Mohd Salman Masri, Erni Noor

Compendium of Oral Science, 2018;5(1):46-53.
MyJurnal

Introduction: High survival rates of dental implants were commonly reported even after 10 years of follow up. Nevertheless, complications and failure may occur and the implant would need to be removed. In recent years, the use of autogenous blood products in dental surgery has increased due to its ability to aid the healing of the soft and hard tissues. Clinical case: The case demonstrated the utilisation of concentrated growth factor (CGF) from the patient’s blood for healing following conservative removal of a failed dental implant. Subsequently, the patient showed satisfactory recovery without any infections and clinical complaints. Conclusion: This explantation procedure, together with the use of CGF, may prevent the normal bone resorption and accelerate soft tissue healing. As it is biological in nature having originated from the patient’s blood, it is more readily accepted by the tissues and the risk of infection is low.

Matched MeSH terms: Device Removal
Stent dislodgement in left anterior descending coronary artery and successful deployment with two parallel wires and a small balloon

Ngow H

Kardiol Pol, 2009 Sep;67(9):1040-2 discussion 1043.
PMID: 19838965

Coronary artery stent dislodgement during angioplasty is a rare complication. Stent dislodgement was more frequent in the past when stents were manually crimped onto the balloon. Newer and improved balloon-mounted stents with better radio-opacity have reduced the incidence of stent dislodgement but do not completely eliminate it. We report a case of balloon-mounted stent dislodgement in the proximal left anterior descending (LAD) coronary artery prior to deployment. This patient however was successfully treated with re-wiring of the artery with two parallel wires and the stent's reposition prior to deployment with the help of a small balloon.

Matched MeSH terms: Device Removal/instrumentation; Device Removal/methods
Fulltext Antegrade repositioning of Memokath stent in malignant ureteroileal anastomotic stricture

Ng KL, Nawawi O, Lim BK, Htun TH, Dublin N, Razack AH

Asian J Surg, 2017 Apr;40(2):171-174.
PMID: 24210538 DOI: 10.1016/j.asjsur.2013.09.012

Ureteric strictures are common and can be due to benign or malignant causes. Various surgical treatments can be used from minimally invasive endoscopic retrograde JJ stent insertion, balloon dilatation, ureterolithotomy, to open surgical exploration and repair. Memokath 051 stent is a metallic stent designed for long-term ureteral stenting in the management of ureteral strictures. The insertion of this device is usually a straightforward procedure performed endoscopically in a retrograde fashion via cystoscopy. However, this procedure can be difficult in complicated scenarios when the bladder has been removed with neoureteral reimplantations or high-grade strictures. Here, we report a case of Memokath stent insertion complicated by placement difficulties in a lady with ileal conduit due to previous ovarian cancer complicated by vesicovaginal fistula, who presented with malignant stricture of the ureteroileal anastomosis. We describe a simple yet effective antegrade technique to precisely reposition the malpositioned Memokath stent, along with illustrations.

Matched MeSH terms: Device Removal
Spontaneous knot formation impeding the removal of a silicone urethral catheter

Mustafa NA, Lope RJ, Cheah FC

Arch. Dis. Child. Fetal Neonatal Ed., 2006 Jul;91(4):F287.
PMID: 16790731
Matched MeSH terms: Device Removal/methods
Opacification of AcriFlex 50CSE hydrophilic acrylic intraocular lenses

Lim AK, Goh PP, Azura R, Mariam I

J Cataract Refract Surg, 2011 Apr;37(4):655-9.
PMID: 21420589 DOI: 10.1016/j.jcrs.2010.10.050

PURPOSE: To determine the prevalence of and risk factors for AcriFlex 50CSE hydrophilic acrylic intraocular lens (IOL) opacification approximately 3 years after implantation.
SETTING: Selayang Hospital, Selangor, Malaysia.
DESIGN: Cross-sectional study.
METHODS: Patients who had AcriFlex 50CSE IOL implantation in 2005 and 2006 were identified from operating logbooks and recalled via telephone and letters. Opaque IOLs were explanted and sent for scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS).
RESULTS: The review showed that 18 patients had died and 67 had declined examination or could not be contacted, leaving 239 eyes for evaluation. The age of the patients ranged from 25 to 85 years. Of the patients, 83 (34.7%) were Malay, 127 (53.1%) Chinese, and 29 (12.1%) East Indian. The male:female ratio was 1:1. Fourteen eyes of 13 patients (5.4%) had IOL opacification; 1 had bilateral opacification. Five eyes had fine deposits, and 9 eyes had dense opaque deposits. Seven opaque IOLs required explantation. There was no correlation between age (P=.645), sex (P=.319), or race (P=.860) and IOL opacification. Pearson chi-square analysis showed a strong association between diabetes mellitus and IOL opacification (P=.019). Nine (69.2%) of the 13 patients with opacification had diabetes. Scanning electron microscopy and EDS showed calcium and phosphate deposits on the optic surface and intralenticularly near the anterior surface of the optic.
CONCLUSIONS: Results indicate that diabetes mellitus is a risk factor for AcriFlex hydrophilic acrylic IOL opacification. In some cases, opacification affected vision, necessitating explantation. The pathophysiology of this complication is unknown.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Matched MeSH terms: Device Removal
Effect of local anesthesia and intravenous sedation on pain perception and vasovagal reactions during femoral arterial sheath removal after percutaneous coronary intervention

Kiat Ang C, Leung DY, Lo S, French JK, Juergens CP

Int J Cardiol, 2007 Apr 4;116(3):321-6.
PMID: 16904773

There is no consensus with respect to the use of analgesia during femoral arterial sheath removal after percutaneous coronary intervention (PCI). We performed a randomized controlled trial to assess the impact of intravenous sedation and local anesthesia during femoral sheath removal after PCI on patient comfort and the incidence of vasovagal reactions.

Matched MeSH terms: Device Removal/adverse effects*
Sonographically guided removal of a double J ureteral stent in an infant

Jutti RC, Subramaniam R, Balsingh D, Qureshi AM

J Clin Ultrasound, 2002 May;30(4):232-5.
PMID: 11981933 DOI: 10.1002/jcu.10062

A 2-month-old male infant with a prenatally diagnosed obstruction of the ureteropelvic junction underwent a dismembered Anderson-Hynes pyeloplasty. A transanastomotic double J ureteral stent was placed between the renal pelvis and the urinary bladder. This report describes the subsequent removal of the double J ureteral stent from the patient's urinary bladder without the aid of a cystoscope: a rigid biopsy forceps was introduced trans-urethrally into the urinary bladder, and the stent was removed with sonographic guidance. Removal of a ureteral stent with sonographic guidance has not been previously reported in infants. This technique may be particularly useful in developing countries, where appropriate-sized cystoscopes and accessories may not be available.

Matched MeSH terms: Device Removal/instrumentation; Device Removal/methods*

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