The stuck catheter: a hazardous twist to the meaning of permanent catheters

Permanent central venous catheter use is associated with significant complications that often require their timely removal. An uncommon complication is resistant removal of the catheter due to adherence of the catheter to the vessel wall. This occasionally mandates invasive interventions for removal...

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Bibliographic Details
Published in:The journal of vascular access 2015-07, Vol.16 (4), p.289-293
Main Authors: Vellanki, Venkat Sainaresh, Watson, Diane, Rajan, Dheeraj K, Bhola, Cynthia B, Lok, Charmaine E
Format: Article
Language:English
Subjects:
Academic Medical Centers
Adult
Aged
Aged, 80 and over
Catheter-Related Infections - microbiology
Catheter-Related Infections - mortality
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - instrumentation
Catheterization, Central Venous - mortality
Catheters, Indwelling - adverse effects
Central Venous Catheters - adverse effects
Databases, Factual
Device Removal
Endovascular Procedures
Female
Humans
Male
Medical Records
Middle Aged
Ontario
Renal Dialysis
Retrospective Studies
Risk Factors
Sternotomy
Time Factors
Treatment Failure
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Summary:Permanent central venous catheter use is associated with significant complications that often require their timely removal. An uncommon complication is resistant removal of the catheter due to adherence of the catheter to the vessel wall. This occasionally mandates invasive interventions for removal. The aim of this study is to describe the occurrence of this "stuck catheter" phenomenon and its consequences. A retrospective review of all the removed tunneled hemodialysis catheters from July 2005 to December 2014 at a single academic-based hemodialysis center to determine the incidence of stuck catheters. Data were retrieved from a prospectively maintained computerized vascular access database and verified manually against patient charts. In our retrospective review of tunneled hemodialysis catheters spanning close to a decade, we found that 19 (0.92%) of catheters were retained, requiring endovascular intervention or open sternotomy. Of these, three could not be removed, with one patient succumbing to catheter-related infection. Longer catheter vintage appeared to be associated with 'stuck catheter'. Retention of tunneled central venous catheters is a rare but important complication of prolonged tunneled catheter use that nephrologists should be aware of. Endoluminal balloon dilatation procedures are the initial approach, but surgical intervention may be necessary.
ISSN:1129-7298
1724-6032
DOI:10.5301/jva.5000392