Retained intravascular catheter fragment at removal of implantable vascular access device: Incidence, risk factors, and outcomes
Topic overview
Retrospective study of 654 IVAD removals in pediatric patients found retained catheter fragments occurred in 0.92% of cases, with risk increasing significantly after 3 years of catheter duration. Conservative management with in-situ retention was successful in most cases, suggesting invasive retrieval is rarely necessary.
Key takeaways
- Retained catheter fragments occur in ~1% of IVAD removals, with risk increasing 3.5-fold per year of indwelling time.
- No retained fragments occurred in IVADs removed before 3 years; duration >3 years is the primary risk factor.
- Conservative management (leaving fragments in situ) is safe in pediatric patients, with most remaining asymptomatic.
- Invasive retrieval is rarely needed; transfixion to surrounding muscle is preferred over endovascular or surgical removal.
- Only one of six cases required intervention due to infected sinus; routine extraction attempts appear unwarranted.
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