Fracture, Retention, Migration, and Retrieval of Peripheral Intravenous Cannula Fragments: A Systematic Review of Published Case Reports and Small Case Series

Kareem, Pavel Mustafa; Ali, Irfan Omer; Rasul, Bashir Mohammed; Khdr, Muhammad Ahmad; Hassan, Paiwand Jamal

doi:10.36582/ksj.2026.170548.1039

Fracture, Retention, Migration, and Retrieval of Peripheral Intravenous Cannula Fragments: A Systematic Review of Published Case Reports and Small Case Series

Document Type : Review

Authors

Pavel Mustafa Kareem ¹

Irfan Omer Ali ¹

Bashir Mohammed Rasul ²

Muhammad Ahmad Khdr ²

Paiwand Jamal Hassan ¹

¹ Nursing Department, Kurdistan Technical Institute, Sulaimani, Kurdistan Region, Iraq

² Department of Adult Nursing, College of Nursing, University of Raparin, Ranya, Sulaymaniyah, Iraq

https://doi.org/10.36582/ksj.2026.170548.1039

Abstract

This study was designed as a systematic review of published case reports and small case series. Study selection and reporting were structured in accordance with PRISMA 2020 and PRISMA-S. Findings were synthesized narratively in line with SWiM, and the full reproducible search strategies are provided in Supplementary File 1. The reproducible PubMed/MEDLINE search identified 21 records, of which 14 publications comprising 20 individual patients were included in the qualitative synthesis. The literature spanned 1992 to 2025, and 9 of the 14 publications (64.3%) were published from 2020 onward. Cases ranged from a day-old neonate to a 76-year-old adult. Events arose predominantly from upper-extremity peripheral venous access and were commonly associated with repeated cannulation attempts, reinsertion of the introducer needle into a partially advanced cannula, device manipulation, or difficult removal. Fragments were usually retained within superficial upper-limb veins, although central embolization to the pulmonary artery or heart/great vessels was documented in 2 of 20 patients (10.0%). Ultrasound and computed tomography were the most informative localization modalities when radiography was negative or inconclusive. Management was predominantly active retrieval, and favorable short-term outcomes were reported in 18 of 20 patients (90.0%). The available case-based evidence suggests that fractured PIVC fragments should be approached as time-sensitive intravascular foreign bodies. These findings support a practical strategy focused on avoiding needle reinsertion and repeated manipulation of the same cannula, together with prompt containment, imaging-based localization, and anatomy-directed retrieval, while recognizing that comparative effectiveness cannot be established from the current literature. Peripheral intravenous cannula; peripheral intravenous catheter; catheter fracture; retained intravascular foreign body; cannula embolization; venotomy; endovascular retrieval; systematic review.

Keywords

Peripheral venous cannula

peripheral venous catheter

catheter fracture

retained intravascular foreign body

cannula bolism