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Catheter fragments embolization

J J Monsuez1, M C Douard, Y Martin-Bouyer

  • 1Emergency Room and Intensive Care Unit, Hôpital Saint-Louis, Paris, France.

Angiology
|February 1, 1997
PubMed
Summary
This summary is machine-generated.

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Central venous silicone catheter rupture and embolization are rare but serious complications. Mechanical deobstruction attempts should be avoided to prevent embolization, as echocardiography is superior to chest roentgenography for diagnosis.

Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Radiology

Background:

  • Central venous silicone catheters are widely used in clinical practice.
  • The incidence and diagnostic challenges of catheter rupture and embolization are not well-established.

Purpose of the Study:

  • To determine the incidence of central venous silicone catheter rupture and embolization.
  • To evaluate diagnostic methods for detecting catheter fragments.
  • To assess the safety of mechanical deobstruction techniques.

Main Methods:

  • A retrospective review of 3916 central venous silicone catheter insertions in 3672 patients over three years.
  • Analysis of complication rates, including catheter embolization.
  • Comparison of diagnostic imaging modalities: chest roentgenography and two-dimensional echocardiography.

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Main Results:

  • Four cases (1.2 embolizations per 1000 patients) of catheter or catheter fragment embolism were identified.
  • Two embolizations were associated with inappropriate mechanical deobstruction attempts.
  • Chest roentgenography missed small fragments within the heart silhouette in two cases.
  • Two-dimensional echocardiography successfully detected catheter fragments in all four cases.

Conclusions:

  • Central venous silicone catheter embolization is an infrequent but significant complication.
  • Mechanical deobstruction should be avoided due to the risk of inducing embolization.
  • Two-dimensional echocardiography is a sensitive and reliable method for diagnosing catheter fragment embolization.