E2428. Checking Out the Chest: A Review of Common and Uncommon Medical Devices in the Chest and Their Complications
  1. Grace Isakson; MD Anderson Cancer Center; The University of Texas Health Science Center at Houston
  2. Kaustubh Shiralkar; Memorial Hermann Health System; The University of Texas Health Science Center at Houston
  3. Steven Chua; Memorial Hermann Health System; The University of Texas Health Science Center at Houston
Radiographic imaging is among the first modalities used to assess the proper placement and to evaluate for potential complications of medical devices. To keep up-to-date, radiologists must be cognizant of new innovations and more conventional devices and their proper placement but to also urgently inform clinicians of device misplacements so that the error can be corrected and the morbidity and mortality of the patient mitigated. This is especially important in the intensive care unit where chest imaging is frequently utilized. Thus, the goal of this exhibit is to review common and uncommon medical devices in the chest and their complications, and to increase the diagnostic acumen of radiologist-in-training and general radiologists.

Educational Goals / Teaching Points
Familiarize radiologists and radiologists in training with common and uncommon medical devices in the chest. Highlight relevant findings of these devices on imaging and their proper location. Delineate complications of these devices. Review notable imaging findings of select complications of these devices.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Medical devices can be the indication for imaging, or the source of pathology, and chest imaging is frequently used to address these issues. Proper placement of devices is often necessary for optimal function, and radiologists play a pivotal role as a gatekeeper to ensure that these devices are placed correctly, as complications can increased mortality and morbidity and even lead to death. Complications may involve bleeding, infection, device failure, pneumothorax, hemothorax, pleural effusion, pericardial effusion, cardiac tamponade, stroke, embolism, thrombosis, anemia, and other events depending on the location and purpose of the device. Many devices in the chest are designed to supplement cardiopulmonary function. For example, the Watchman device is designed to mitigate the risk of hypercoagulable states such as atrial fibrillation, while the SynCardia device functions as an artificial heart. In extracorporeal membrane oxygenation (ECMO), catheters provide support for cardiopulmonary systems.

The proper placement of a medical device is essential to optimize its function and to improve the outcomes of the patients. Towards this goal, radiologists play an important gatekeeper role in ensuring that medical devices are placed correctly and must urgently inform clinicians of misplacement so that the error can be corrected in a timely fashion to improve the mortality and morbidity of the patients.