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Related Experiment Video

Updated: Jun 4, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
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[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
PubMed
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.

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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.