Background: Transcatheter occlusion techniques have become a successful alternative to surgical procedures. Recent studies have shown that the device embolization occurs in up to 0.55% of cases performed .
Aim of our study: To know the incidence of embolization and report the novel techniques for retrieval.
439 cases underwent transcatheter closure with Amplatzer septal or duct occluder. Age ranging from 4 months to 65 years, mean 6.4 +/-9. Cause of embolisation and the challenges faced during the retrieval in 3 cases (0.68%) were meticulously recorded. One device embolized into aorta, was pushed into left common iliac artery so that the retention skirt was above and female end of the screw was below . Then the screw was fastened inside the common iliac artery and the device was retrieved. One 14/12 Angled Amplatzer duct occluder device embolized into the main pulmonary artery, was caught by snare and pulled. Unfortunately the device could not be pulled out as the sheath got telescoped. Dilator was introduced to straighten the sheath and simultaneously device tip was pulled into the sheath and retrieved. In another case of long tortuous PDA with acute bend, 12/10 occluder was dangling, as it migrated towards the LPA and attempt to retrieve and reposition failed. Ultimately,device was pulled, so that pulmonary end was facing the main pulmonary artery and device was caught by the snare and retrieved.
Conclusion : Rarely device embolisation can cause nightmare in cathlab. One has to use innovative nonstandardized devices, novel techniques and strategies for retrieval.