Successful Removal of a Fractured Desilets-Hoffman Sheath in a Patient With a Loop Arteriovenous Graft: Balloon-Supported Retrieval Technique

• Published in: Vascular and endovascular surgery Vol. 58; no. 4; pp. 448 - 451
• Main Authors: Choi, Yoon Seo, Oh, Chang Hoon
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-2024
• Subjects: Aged; Angioplasty, Balloon; Arteriovenous Shunt, Surgical - adverse effects; Female; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - surgery; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Renal Dialysis - adverse effects; Treatment Outcome; hemodialysis; percutaneous retrieval; catheter fracture; fistula; arteriovenous fistula
• ISSN: 1538-5744; 1938-9116
• DOI: 10.1177/15385744231217617

Introduction
While a Desilets–Hoffman sheath rarely fractures, when it does, the presence of an intravenous foreign body can cause various complications.
Case Presentation
A 74-year-old woman receiving hemodialysis for end-stage renal disease via a left forearm arteriovenous graft (AVG) was referred to the interventional radiology department following thrombotic occlusion of the AVG. A corrective procedure was initiated, and the 7F Desilets–Hoffman sheath fractured after the purse-string suture. A .035-inch guidewire was passed through the fractured sheath, and a 3.0-mm x 60-mm balloon catheter was inflated, allowing for the successful removal of the sheath fragment without complications.
Conclusion
The fractured Desilets-Hoffman sheath was successfully removed in a patient with a loop arteriovenous graft using balloon-supported retrieval technique.