Peripherally inserted central catheters: resistance to removal: a rare complication

Peripherally inserted central catheters that resist removal occur in 8 of 829 catheters (0.965%). Several causes may be responsible as the reason for this phenomenon, such as infectious process, fibrin formation, and endothelial thrombosis. This article describes venospasm as confirmed by ultrasound as the cause. Removal in all but one catheter was completed in approximately 1 hour with gentle pulling, taped tension, and warm soaks for 20 minutes. Tourniquet application and gentle traction were employed. If unsuccessful, the tourniquet was removed and warm soaks reapplied. One catheter did not respond to this recommended treatment and was stuck for six days. Treatment of catheter embolus is outlined should the catheter be inadvertently broken during the removal process.