Retrograde migration and endovascular retrieval of a venous bullet embolus

• Published in: Journal of vascular surgery Vol. 53; no. 4; pp. 1113 - 1115
• Main Authors: Schroeder, Mary Elizabeth, MD, Pryor, Howard I., MD, Chun, Albert K., MD, Rahbar, Rodeen, MD, Arora, Subodh, MD, Vaziri, Khashayar, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2011; Elsevier
• Subjects: Adult; Anticoagulants - therapeutic use; Biological and medical sciences; Cardiovascular system; Embolism - diagnostic imaging; Embolism - etiology; Embolism - therapy; Endovascular Procedures; Enoxaparin; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - etiology; Foreign-Body Migration - therapy; Humans; Iliac Vein - diagnostic imaging; Male; Medical sciences; Pharmacology. Drug treatments; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tomography, X-Ray Computed; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular wall; Wounds, Gunshot - complications; Wounds, Gunshot - diagnostic imaging; Wounds, Gunshot - therapy; Cardiovascular disease; Endovascular route; Surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2010.11.046

Venous bullet embolism is a rare and complicated occurrence reported in approximately 0.3% of penetrating trauma. The management of bullet emboli is decided on a case-by-case basis, balancing the risk of the embolus itself against those associated with extraction. We report a case of a 19-year-old man who sustained a gunshot wound to the anterior chest, which migrated to the left internal iliac vein in a retrograde fashion. We were able to successfully retrieve the missile using an endovascular approach, thereby minimizing the morbidity associated with an open procedure.