Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate

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Traditional surgical removals are often risky and may not be feasible in these patients. This case report aims to detail a successful endovascular approach for IFB retrieval in a severely preterm neonate. Case This is a case report of a 14-day old, male 30-week gestation neonate with a retained umbilical catheter fragment. The baby was referred after an unsuccessful explorative laparotomy by a paediatric surgery team. The endovascular procedure was performed using a 4 French (Fr) vertebra catheter and a One Snare wire in the right femoral region under low-dose fluoroscopy. The IFB was successfully removed. Post-procedure, the patient’s leukocyte count normalized, and he transitioned from ventilator support to a nasal cannula and eventually to room air within three days. The neonate could also tolerate oral intake, signalling a rapid recovery and low morbidity. Conclusions This case report highlights the potential of endovascular approaches for IFB retrieval as viable alternatives to traditional surgeries, especially in neonates where surgical options are limited or have failed. Further research is needed to standardize such minimally invasive techniques in neonatal care. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-55", "name": "Case Report: Endovascular technique for intravascular foreign body..." } } ] } Home Browse Case Report: Endovascular technique for intravascular foreign body... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Darmawan MR, Wahyono DA, Pasiak TF et al. Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.12688/f1000research.142275.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Case Report Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] Marsha Ruthy Darmawan https://orcid.org/0000-0002-6514-7615 1 , Djuwita Adi Wahyono https://orcid.org/0009-0009-6681-5142 2 , Taufiq Fredrik Pasiak 2 , Listyo Julia 3 , Irhamni Irhamni 4 , Terawan Agus Putranto https://orcid.org/0009-0001-7493-1487 1,2 Marsha Ruthy Darmawan https://orcid.org/0000-0002-6514-7615 1 , Djuwita Adi Wahyono https://orcid.org/0009-0009-6681-5142 2 , [...] Taufiq Fredrik Pasiak 2 , Listyo Julia 3 , Irhamni Irhamni 4 , Terawan Agus Putranto https://orcid.org/0009-0001-7493-1487 1,2 PUBLISHED 11 Jan 2024 Author details Author details 1 Department of Radiology, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia 2 Department of Radiology, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, DKI Jakarta, 10430, Indonesia 3 Department of Anesthesiology, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia 4 Department of Pediatric Surgery, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia Marsha Ruthy Darmawan Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Djuwita Adi Wahyono Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Taufiq Fredrik Pasiak Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Listyo Julia Roles: Conceptualization, Formal Analysis, Funding Acquisition, Project Administration, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Irhamni Irhamni Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Terawan Agus Putranto Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Intravascular foreign bodies (IFB) in severely preterm neonates present critical clinical challenges. Traditional surgical removals are often risky and may not be feasible in these patients. This case report aims to detail a successful endovascular approach for IFB retrieval in a severely preterm neonate. Case This is a case report of a 14-day old, male 30-week gestation neonate with a retained umbilical catheter fragment. The baby was referred after an unsuccessful explorative laparotomy by a paediatric surgery team. The endovascular procedure was performed using a 4 French (Fr) vertebra catheter and a One Snare wire in the right femoral region under low-dose fluoroscopy. The IFB was successfully removed. Post-procedure, the patient’s leukocyte count normalized, and he transitioned from ventilator support to a nasal cannula and eventually to room air within three days. The neonate could also tolerate oral intake, signalling a rapid recovery and low morbidity. Conclusions This case report highlights the potential of endovascular approaches for IFB retrieval as viable alternatives to traditional surgeries, especially in neonates where surgical options are limited or have failed. Further research is needed to standardize such minimally invasive techniques in neonatal care. READ ALL READ LESS Keywords Endovascular, interventional radiology, intravascular foreign body, preterm, neonate Corresponding Author(s) Terawan Agus Putranto ( [email protected] ) Close Corresponding author: Terawan Agus Putranto Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Darmawan MR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Darmawan MR, Wahyono DA, Pasiak TF et al. Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.12688/f1000research.142275.1 ) First published: 11 Jan 2024, 13 :55 ( https://doi.org/10.12688/f1000research.142275.1 ) Latest published: 11 Jan 2024, 13 :55 ( https://doi.org/10.12688/f1000research.142275.1 ) Introduction Intravascular foreign bodies (IFB) in severely preterm neonates present a significant clinical challenge fraught with multiple risks including infection, vascular injury, and even death. Such events are exceedingly rare yet demand immediate attention given the vulnerable nature of the neonatal patient population. 1 Traditional surgical approaches for foreign body removal are not only risky but may also not be feasible due to the extremely delicate anatomical structures and limited physiologic reserves of preterm neonates. Therefore, safer and minimally invasive interventions are often preferred. 2 Endovascular techniques have gained prominence in adult and paediatric populations for various applications, including foreign body retrieval, because of their less invasive nature and shorter recovery time. However, the literature describing the efficacy, safety, and technical aspects of endovascular interventions for foreign body retrieval in severely preterm neonates is sparse. 2 – 4 This case report aims to detail a successful endovascular approach for intravascular foreign body retrieval in a severely preterm neonate. By doing so, we hope to contribute valuable information to the limited pool of knowledge on this subject and offer clinicians an alternative approach that could potentially minimize surgical risks while ensuring effective treatment. This case report is reported according to the CARE (case report guidelines) 2017 criteria. 5 Case report A 14-day old, Asian, male preterm neonate was referred to Gatot Soebroto Army Hospital, Indonesia due to intravascular foreign body. Previously, the neonate was born during his 30 weeks of gestation with birth weight of only 1,600 grams and birth height of 39 cm. He was then admitted to the neonatal intensive care unit (NICU) due to respiratory distress. During his admission, an umbilical catheter was placed for vascular access, and he was intubated. A week following the birth, his condition had improved, he was extubated and had continuous positive air pressure (CPAP) worn. However, a fragment of the umbilical catheter was left behind. Two intravenous antibiotics (ampicillin and gentamicin) were administered to the patient for over a week; however, his condition did not improve. During the physical examination, his respiratory rate was 55 times a minute with heart rate of 168 times per minute and peripheral oxygen saturation of 96% on ventilator. His laboratory results were significant for leucocytosis with normal thrombocyte and C-reactive protein. The other laboratory results were unremarkable. Based on the thoracoabdominal X-ray imaging, a radiopaque catheter was found at the right paravertebral region, behind the liver, at the level of Th8-L2 and pulmonary infiltrate ( Figure 1 ). Figure 1. The preliminary thoracoabdominal X-ray image showing a radiopaque catheter at the right paravertebral region. Following admission, the patient underwent explorative laparotomy by the paediatric surgeon team in order to extract the foreign body but to no avail. He was then referred to the interventional radiology department for intravascular foreign body extraction using endovascular approach. During the procedure, an aseptic and antiseptic action was performed in the right femoral region, where attempts were made to puncture the vein using a 21 Gauge (G) needle under ultrasound guidance. After several unsuccessful attempts at venous puncture, to expedite the process for the patient, a venous incision was performed by the paediatric surgeon team. Following exposure of the femoral vein, puncture was successfully achieved with a 21 Gauge needle, followed by the insertion of a 0.032” guide wire (Terumo ® , Tokyo) under low-dose fluoroscopy in the cath lab. Subsequently, a 4 French (Fr) introducer sheath and a 4 Fr vertebra catheter (Terumo ® , Tokyo), along with a longer guide wire, were threaded through the sheath and directed towards the inferior vena cava. With precision, an exchange was made using the catheter and the 10 mm, 4 Fr One Snare wire (Merit Medical ® , Ireland), which were manoeuvred to encircle the foreign body with its looped wire. Once securely ensnared, the foreign body (the umbilical catheter) was gently extracted. The instruments were subsequently removed, completing the procedure successfully ( Figure 2 ). Figure 2. The process of intravascular foreign body extraction. (a) Insertion of guide wire. (b) Insertion of One Snare wire (c). Encirclement of the foreign body with looped wire. (d) Extraction of the foreign body. (e) The foreign body was carried along to the puncture site. After the surgery, a 5 cm long umbilical catheter was extracted from the inferior vena cava of the patient ( Figure 3 ). Two days following the procedure, his clinical condition had improved. The patient had switched to nasal canula on the second postoperative day and had no supplementary oxygen on the third postoperative day. Oral intake was started on the third postoperative day, which was well-tolerated by the patient. Figure 3. The extracted 5 cm long umbilical catheter. Discussion IFB is one of the most severe iatrogenic complications of catheterization. 2 , 3 It is especially dangerous in neonates who have delicate anatomical structures and limited physiologic reserves. 2 , 4 However, the umbilical vein catheters are widely used in critical care of the neonates for rapid and dependable central access in preterm babies. Other than being displaced and left behind, injury to other organ during insertion, infection, thromboembolism, fracture of the catheter causing embolization, and even cardiac perforation are notable complications of umbilical vein catheters. 1 The case presented herein exemplifies the challenges and complexities associated with IFB retrieval in a severely preterm neonate. Traditional surgical interventions, as attempted initially, proved to be unfruitful for the removal of the IFB in this case. This highlights the anatomical and physiological constraints that traditional surgical methods encounter in such vulnerable patients. Our experience underscores the utility of an endovascular approach as an alternative, especially when conventional surgical techniques fail or are not feasible. Notably, the minimally invasive nature of the procedure, guided by real-time imaging, allowed for a targeted intervention that minimized tissue disruption and potential complications. Similar imaging technique (low dose fluoroscopy) has been used by some studies about intravascular foreign body retrieval in neonates. 2 Given the severely preterm neonate’s frail constitution and the high risks associated with invasive surgical procedures, the endovascular approach offered a less traumatic and more controlled methodology for IFB retrieval. There are several techniques in performing endovascular extraction of intravascular foreign bodies, such as gripping the foreign body from outside using a snare or forceps, displacing the foreign bodies using balloons or stone retrieval baskets, or using a guidewire and low-profile balloons to grasp the foreign body. 2 , 6 However, gripping the foreign body is only feasible in relatively large vascular channel, not in smaller vessels such as in neonatal cases. 2 Moreover, there are a few purpose-designed devices for intravascular foreign bodies retrieval, such as Amplatz gooseneck (ev3), Trefoiel En-Snare (Merit Medical), Dormia baskets, Alligator retrieval forceps (Cook Medical and ev3), and Myocardial biopsy forceps (Cook Medical). 3 These devices can have a range of sizes, variable range of emergences (from 0 degree to 90 degree) and more than one loops, greatly enhancing the manipulation techniques of the IFB retrieval. 6 In this case, there are several unique technical challenges, such as difficulty in venous puncture, which requires venous incision by paediatric surgeon team and the use of specialized equipment like a 4 Fr vertebra catheter and the One Snare wire. This technique is also explained by Rossi et al. (2018) using the name of “ Loop snare grasp-guide wire technique ” . 6 The manipulation of these instruments is crucial and should be undertaken by healthcare providers with expertise in endovascular techniques, especially in such a delicate patient population. The marked improvement in the patient’s condition post-procedure emphasizes the effectiveness of this approach. Successful removal of the umbilical catheter led to clinical improvements including normalized leukocyte counts and better tolerance to oral intake. Similar results was found after the extraction of embolized umbilical catheter in preterm neonates in other studies. 1 , 2 Furthermore, the immediate postoperative course, with a quick switch from ventilator support to nasal cannula and eventually to room air, suggests shorter recovery time and lower morbidity, corroborating the benefits of a minimally invasive approach. The successful removal of an intravascular foreign body via endovascular technique in a severely preterm neonate highlights the potential of this approach as a viable alternative to more invasive surgical procedures. However, it is imperative to recognize the technical nuances and challenges involved, especially in this fragile patient population. This case serves not only as a testament to the evolving capabilities of minimally invasive techniques but also as an invitation for further research to optimize and standardize such approaches in neonatal care. Consent Written informed consent for publication of their clinical details and clinical images was obtained from the guardian of the patient. Data availability All data underlying the results are available as part of the article and no additional source data are required. Acknowledgements The authors would like to thank Gatot Soebroto Central Army Hospital and University of Pembangunan Nasional “Veteran” Jakarta Indonesia. References 1. Patel J, Ramarao S, Desai J, et al. : A case report of embolized umbilical venous catheter retrieval from the heart via femoral access in 660 g premature neonate. Radiol Case Rep. 2019; 14 : 1415–1419. PubMed Abstract | Publisher Full Text | Free Full Text 2. Yadav MK, Pillai R, Unni M, et al. : Iatrogenic Intravascular Foreign Body Retrieval in a Neonate. J. Clin. Interv. Radiol. ISVIR. 2020; 4 : 130–132. Publisher Full Text 3. Woodhouse JB, Uberoi R: Techniques for intravascular foreign body retrieval. Cardiovasc. Intervent. Radiol. 2013; 36 : 888–897. Publisher Full Text 4. Pazinato LV, Leite TF d O, Bortolini E, et al. : Percutaneous retrieval of intravascular foreign body in children: a case series and review. Acta Radiol. 2022; 63 : 684–691. PubMed Abstract | Publisher Full Text 5. Riley DS, Barber MS, Kienle GS, et al. : CARE guidelines for case reports: explanation and elaboration document. J. Clin. Epidemiol. 2017; 89 : 218–235. PubMed Abstract | Publisher Full Text 6. Rossi UG, Rollandi GA, Ierardi AM, et al. : Materials and techniques for percutaneous retrieval of intravascular foreign bodies. J. Vasc. Access. 2018; 20 : 87–94. Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 11 Jan 2024 ADD YOUR COMMENT Comment Author details Author details 1 Department of Radiology, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia 2 Department of Radiology, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, DKI Jakarta, 10430, Indonesia 3 Department of Anesthesiology, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia 4 Department of Pediatric Surgery, Gatot Soebroto Central Army Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia Marsha Ruthy Darmawan Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Djuwita Adi Wahyono Roles: Conceptualization, Data Curation, Funding Acquisition, Investigation, Methodology, Project Administration, Software, Validation, Writing – Original Draft Preparation, Writing – Review & Editing Taufiq Fredrik Pasiak Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Listyo Julia Roles: Conceptualization, Formal Analysis, Funding Acquisition, Project Administration, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Irhamni Irhamni Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Terawan Agus Putranto Roles: Conceptualization, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 11 Jan 2024, 13:55 https://doi.org/10.12688/f1000research.142275.1 Copyright © 2024 Darmawan MR et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Darmawan MR, Wahyono DA, Pasiak TF et al. Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.12688/f1000research.142275.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 11 Jan 2024 Views 0 Cite How to cite this report: Jain N. Reviewer Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r349487 ) The direct URL for this report is: https://f1000research.com/articles/13-55/v1#referee-response-349487 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Dec 2024 Naveen Jain , Kerala Institute of Medical Sciences, Trivandrum, Kerala, India; neonatology, KIMSHEALTH Trivandrum (Ringgold ID: 76137), Thiruvananthapuram, Kerala, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.155809.r349487 Important and relevant information. Well written article. Alll details of the case and management details are clearly elucidated, will help many similar high risk babies, an abdominal surgery may be avoided if such ... Continue reading READ ALL Important and relevant information. Well written article. Alll details of the case and management details are clearly elucidated, will help many similar high risk babies, an abdominal surgery may be avoided if such information is known to neonatologist . We have reported a similar case of a term born baby (yadav et al; included in the references) The article can be indexed. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: neonatology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Jain N. Reviewer Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r349487 ) The direct URL for this report is: https://f1000research.com/articles/13-55/v1#referee-response-349487 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Behera TR. Reviewer Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r267553 ) The direct URL for this report is: https://f1000research.com/articles/13-55/v1#referee-response-267553 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 17 May 2024 Tapas Ranjan Behera , Cleveland Clinic, Cleveland, Ohio, USA Approved VIEWS 0 https://doi.org/10.5256/f1000research.155809.r267553 Strengths & weaknesses: Unique report regarding a complex case of entrapment of umbilical catheter fragment in a pre-term neonate that was successfully managed by endovascular retrieval of the foreign body. Elaboration and discussion about the possible causes of foreign body ... Continue reading READ ALL Strengths & weaknesses: Unique report regarding a complex case of entrapment of umbilical catheter fragment in a pre-term neonate that was successfully managed by endovascular retrieval of the foreign body. Elaboration and discussion about the possible causes of foreign body entrapment in this case would make the report informative. Short summary & relevance: Intravascular foreign body retrieval in neonates are critical to deal with, more so when the neonate is pre-term. The authors have described the effective removal of the foreign body by the endovascular approach. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Surgical improvisation, Cancer Therapy. Past experience with similar case of lodged peritoneal dialysis catheter which had lead to a published case report. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Behera TR. Reviewer Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r267553 ) The direct URL for this report is: https://f1000research.com/articles/13-55/v1#referee-response-267553 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 11 Jan 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 1 11 Jan 24 read read Tapas Ranjan Behera , Cleveland Clinic, Cleveland, Ohio, USA Naveen Jain , Kerala Institute of Medical Sciences, Trivandrum, India; KIMSHEALTH Trivandrum (Ringgold ID: 76137), Thiruvananthapuram, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Jain N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Dec 2024 | for Version 1 Naveen Jain , Kerala Institute of Medical Sciences, Trivandrum, Kerala, India; neonatology, KIMSHEALTH Trivandrum (Ringgold ID: 76137), Thiruvananthapuram, Kerala, India 0 Views copyright © 2024 Jain N. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Important and relevant information. Well written article. Alll details of the case and management details are clearly elucidated, will help many similar high risk babies, an abdominal surgery may be avoided if such information is known to neonatologist . We have reported a similar case of a term born baby (yadav et al; included in the references) The article can be indexed. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise neonatology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Jain N. Peer Review Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r349487) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-55/v1#referee-response-349487 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Behera T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 17 May 2024 | for Version 1 Tapas Ranjan Behera , Cleveland Clinic, Cleveland, Ohio, USA 0 Views copyright © 2024 Behera T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Strengths & weaknesses: Unique report regarding a complex case of entrapment of umbilical catheter fragment in a pre-term neonate that was successfully managed by endovascular retrieval of the foreign body. Elaboration and discussion about the possible causes of foreign body entrapment in this case would make the report informative. Short summary & relevance: Intravascular foreign body retrieval in neonates are critical to deal with, more so when the neonate is pre-term. The authors have described the effective removal of the foreign body by the endovascular approach. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Surgical improvisation, Cancer Therapy. Past experience with similar case of lodged peritoneal dialysis catheter which had lead to a published case report. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Behera TR. Peer Review Report For: Case Report: Endovascular technique for intravascular foreign body retrieval in severely preterm neonate [version 1; peer review: 2 approved] . F1000Research 2024, 13 :55 ( https://doi.org/10.5256/f1000research.155809.r267553) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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