The removal of a stuck catheter: an alternative to Hong's technique

Area of Science:

• Nephrology
• Vascular Surgery
• Interventional Radiology

Background:

• Tunneled central venous catheters (CVCs) are increasingly used for hemodialysis vascular access worldwide.
• Extended use and device longevity are linked to a rise in complications, including "embedded" or stuck catheters.
• Difficulty in CVC removal after cuff detachment is a growing clinical concern.

Observation:

• The "embedded" or stuck catheter complication occurs when a CVC cannot be removed following cuff detachment.
• Existing literature describes various methods for stuck CVC removal.
• Endoluminal dilation (Hong's Technique), modified by Quaretti and Galli, is currently the most common and safest removal method.

Findings:

• This paper introduces a novel technique utilizing a Vollmar ring for the removal of stuck CVCs.
• The Vollmar ring technique is presented as an alternative to Hong's Technique.
• It is also proposed as a salvage option following failed attempts with Hong's Technique.

Implications:

• This new technique expands the armamentarium for managing difficult CVC removals.
• It may offer a safer or more effective solution for embedded CVCs, particularly when standard methods are unsuccessful.
• Improved CVC removal strategies can reduce patient morbidity and healthcare costs associated with hemodialysis access complications.