Related Experiment Videos
[Knotted intravascular catheters--what should be done?]
E S Debus1, A Larena-Avellaneda, C Markus
1Abteilung für Allgemein-, Gefäss- und Viszeralchirurgie, Allgemeines Krankenhaus Harburg, Hamburg.
Zentralblatt Fur Chirurgie
|October 9, 2003
Summary
Knotted intravascular catheters often require removal. Radiological intervention successfully removes most catheters, but surgical removal carries significant risks and complications for patients.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Intravascular catheter knotting is a significant clinical problem.
- Catheter removal can involve interventional or surgical approaches, each with associated risks.
Observation:
- A review of 115 cases of "lost" catheters identified Swan-Ganz catheters as the most common type (46.1%).
- Radiological interventions achieved successful removal in 60.9% of cases.
- Open surgical revision was required in 33% of cases, with higher morbidity and mortality observed when catheters were left in situ due to patient instability.
Findings:
- The study analyzed two cases of knotted catheters requiring surgical intervention (sternotomy and internal jugular vein exploration), both successful.
- Literature review indicated that radiological intervention is the primary method for removing "lost" intravascular catheters.
- Open surgical therapy is necessary for approximately one-third of cases and is associated with considerable risks.
Implications:
- Minimally invasive radiological techniques should be prioritized for "lost" intravascular catheter removal.
- Surgical interventions for knotted catheters carry substantial risks and should be reserved for cases where less invasive methods fail.
- Understanding catheter knotting patterns and optimizing removal strategies can improve patient outcomes and reduce procedural complications.