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Updated: Jun 4, 2026
05:21
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
[Knot in a thoracic epidural catheter]
F Fischer1, O Helms, J-G Hentz
1Service d'anesthésie-réanimation, hôpitaux universitaires de Strasbourg, 1 place de l'Hôpital, Strasbourg, France. ffischer67@free.fr
Annales Francaises D'Anesthesie Et De Reanimation
|February 2, 2011
Summary
A thoracic epidural catheter became knotted during insertion, making removal difficult. The catheter was successfully retrieved without complications, highlighting potential risks in thoracic epidural placement.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Thoracic epidural catheterization is a common procedure for analgesia.
- Complications during catheter insertion and removal can occur, though knots are rare.
- Anatomical variations in the thoracic region may predispose to complications.
Observation:
- A case of impossible injection into a thoracic epidural catheter at the T3-T4 level is reported.
- Difficulties were encountered during catheter withdrawal due to an unexpected knot.
- The catheter was successfully removed with gentle traction, revealing a simple knot near the tip.
Findings:
- The formation of a knot in a thoracic epidural catheter is possible, even in the high thoracic region.
- Anatomical structures may cause the catheter to take an abnormal direction during insertion.
- No neurological complications were observed post-removal.
Implications:
- This case underscores the importance of careful catheter advancement without resistance during thoracic epidural placement.
- Awareness of potential knotting complications is crucial for anesthesiologists and pain management specialists.
- Further investigation into anatomical factors influencing thoracic epidural catheter behavior may be warranted.
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