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Approach to fragmented central venous catheters
Bedrettin Yildizeli1, Tunç Laçin, Feyyaz Baltacioğlu
1Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
Vascular
|July 6, 2005
Summary
Fragmented central venous catheters in cancer patients are rare but can cause malfunction. This study found that the Amplatz gooseneck snare safely removed fragments, preventing complications and restoring function.
Area of Science:
- Interventional Radiology
- Oncology
- Vascular Access
Background:
- Prolonged central venous access is crucial for cancer patient treatment.
- Catheter fragmentation is a rare but serious complication leading to device malfunction.
- Subclavian vein catheter placement can predispose to narrowing and breakage.
Purpose of the Study:
- To present the experience in managing fragmented central venous catheters.
- To evaluate the safety and efficacy of the Amplatz gooseneck snare for fragment removal.
- To identify causes and diagnostic methods for catheter fragmentation.
Main Methods:
- Retrospective review of 183 central venous catheter placements between 2001-2003.
- Diagnosis of fragmentation via chest radiography.
- Removal of fragments using the Amplatz gooseneck snare with angiographic guidance.
Main Results:
- Five cases (2.7% incidence) of fragmented catheters were observed.
- All fragments were successfully removed using the Amplatz snare without complications.
- Catheter malfunction was primarily attributed to medial positioning in the subclavian vein.
Conclusions:
- Catheter fragmentation, though rare, necessitates prompt diagnosis and intervention.
- The Amplatz gooseneck snare is a safe and effective method for removing fragmented catheters.
- Radiologic evaluation is essential for diagnosing catheter rupture and guiding management.