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Spontaneous Knot Formation in a Central Venous Catheter
Carolina Bortolozzo Graciolli Facanali1, Vanessa Simões Paixão2, Carlos Walter Sobrado1
1Department of Gastroenterology, University of São Paulo, School of Medicine, São Paulo, SP, Brazil.
The American Journal of Case Reports
|September 15, 2021
Summary
Central venous catheter (CVC) knotting is a rare but serious complication. Early identification and management are crucial to prevent severe outcomes like catheter fragmentation and venous injury.
Area of Science:
- Vascular Surgery
- Critical Care Medicine
- Radiology
Background:
- Central venous catheterization (CVC) is vital for critically ill patients, enabling drug administration and nutritional support.
- CVC procedures carry risks including mechanical, infectious, and thrombotic complications.
- Catheter knotting is an infrequent but significant complication of CVC placement.
Observation:
- A case report details a 63-year-old male patient experiencing cardiogenic shock requiring CVC insertion.
- The inserted CVC in the right jugular vein failed to achieve blood flow, raising suspicion of knotting.
- Chest X-ray confirmed a tight knot approximately 2 cm from the catheter tip.
Findings:
- The study highlights catheter knotting as a rare obstruction complication.
- Successful removal of the knotted catheter was achieved through venotomy.
- Prompt recognition is key to avoiding severe consequences.
Implications:
- This case underscores the importance of considering catheter knotting in cases of absent blood flow.
- Radiological follow-up is recommended for patients with challenging anatomy.
- Encouraging echo-guided catheterization may reduce the incidence of such complications.
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