Exchanging dual-lumen central venous catheters: how I do it

Area of Science:

• Vascular Access Management
• Interventional Radiology
• Nephrology

Background:

• Traditional management of blocked long-term central venous catheters involves removal and re-siting.
• This approach is suboptimal, especially when venous thrombosis or sepsis are absent.
• Limited central venous access sites necessitate alternative management strategies.

Purpose of the Study:

• To describe a novel technique for exchanging long-term central venous catheters with uncomplicated device failure.
• To preserve the existing venous access site and subcutaneous tunnel.
• To provide an alternative to catheter removal and re-siting.

Main Methods:

• A technique involving division of the dual-lumen catheter.
• Securing the venous access site and subcutaneous tunnel with separate peel-away sheaths.
• Introduction of a new catheter through the sheaths, followed by sheath removal.

Main Results:

• Successful salvage of the venous access site and subcutaneous tunnel.
• Avoidance of catheter removal and re-siting.
• Demonstration of applicability to internal jugular and subclavian catheters.

Conclusions:

• The described technique offers a viable method for exchanging long-term central venous catheters.
• Preservation of central venous access sites is a key advantage.
• This approach is beneficial for patients with limited access options and uncomplicated device failure.