The sandwich technique used for retrieving embolized catheter fragment dislodged in the pulmonary artery.

A catheter fragment migrating to the right atrium or the pulmonary artery can usually be retrieved by using a well-known two-step method. The method involves first making a free end with a pigtail catheter, and second seizing it with a snare loop. In recent years, several methods based on the two-step method have been developed to easy the retrieving procedures. However, sometimes the free ends of the catheter fragment are inaccessible or the fragment cannot stand still because of the blood flow and heartbeat. These methods are unavailable in such situations. Here we present a case report with peripherally inserted central catheter (PICC) fragment dislodged to the right main pulmonary artery without free ends managed by a new method. This new method includes three steps. First, use a pigtail catheter to drag the fragment away from the pulmonary artery or the right ventricle to the right common iliac vein. Second, advance a 0.014-inch wire through the coiled the fragment. Third, use the snare loop to seize the tip of the 0.014-inch wire. In the end, retrieve all of them together. We name this three-step method the "sandwich technique" which exhibits several advantages in the realm of retrieving catheter fragment dislodged to the right atrium or the pulmonary artery.