Related Experiment Videos
Long-term silastic catheters and chest pain
M E Passaro1, E Steiger, S Curtas
1Department of General Surgery, Cleveland Clinic Foundation, OH 44195.
Summary
Long-term central venous catheters can migrate, causing vascular erosion. This study shows Silastic catheter repositioning relieved chest pain in patients with migrated catheters eroding the superior vena cava.
Area of Science:
- Vascular Surgery
- Medical Device Complications
- Intravenous Therapy
Background:
- Central venous catheters are crucial for long-term intravenous therapy.
- Vascular erosion, including superior vena cava perforation, is a known complication.
- Catheter malposition is a suspected precursor to erosion.
Observation:
- Three patients with long-term indwelling Silastic catheters experienced chest pain during total parenteral nutrition infusion.
- Chest X-rays revealed catheter tips had migrated and were against the superior vena cava sidewall.
- The catheters were initially placed in the left side but migrated over time.
Findings:
- Migration of long-term Silastic central venous catheters can lead to vascular erosion.
- Catheter tips angled toward the vein wall, due to movement, can cause endothelial injury.
- Prompt symptom relief occurred after catheter removal and replacement on the right side.
Implications:
- Delayed recognition of catheter malposition can have severe consequences.
- Careful monitoring of long-term catheter position is essential.
- Right-sided catheter placement may reduce the risk of superior vena cava erosion.