Polyurethane versus silicone port a cath: What's going on at removal?

Infographic · Oct 2018 · 1 min read

In brief

Retrospective study of 216 pediatric port-a-cath removals found polyurethane catheters had significantly higher fracture rates (9.2%) compared to silicone catheters (0%), with risk increasing after 2 years in situ. Authors recommend switching to silicone-based catheters and limiting duration to 2 years maximum to prevent retained fragments.

Polyurethane port-a-caths fractured in 9.2% of removals (11/119) while silicone catheters had zero fractures (0/86)
Fracture risk in polyurethane catheters increases significantly with duration in place, especially beyond 2 years
Silicone-based catheters demonstrate superior durability and should be preferred for long-term venous access
Routine removal of all port-a-caths within 2 years may reduce catheter fracture and retained fragment complications

Written by the GCMD Library team from the infographic.

The infographic uses a split-screen layout with two anatomical torso diagrams showing central line placement. The left side (polyurethane) is highlighted in dark green, the right side (silicone) also in dark green. Both show simplified chest anatomy with a catheter entering near the clavicle. A blue banner spans the top, and teal text boxes appear at the bottom with key takeaways.

Background

Port-a-cath (PAC) is an essential device in the management of the patients of chronic illness, but despite theirs benefits there are many complications either at the time of insertion or at time of removal. Our aim of this study is to evaluate the fracture rate of the catheter at removal time in comparison with catheter type either polyurethane or silicone.

Methods

A retrospective monocentric study of all PACs which were removed at our university pediatric hospital between 1 January 2006 and 31 December 2016. Two groups were compared: polyurethane group and silicone group.

Results

Total of 216 central lines were removed, the mean age at the time of extraction was 9.7 ± 4.9 years and the mean time for both catheter was 2.7 ± 1.6 years, fracture occurred in 11 catheter of the polyurethane group (n = 119), with no fracture of silicone group (n = 86), in the polyurethane group, the risk of catheter fracture is significantly related to the duration of the PAC in place.

Conclusion

We found that the polyurethane-based catheters are more vulnerable for rupture and retained fragment in the blood vessels, especially if left in place for long time, for this reason we have switched to silicone-based catheter and all catheters should be remove within duration maximal of 2 years.

Type of study

Prognosis study.

Level of evidence

Level II.

The text in the image

For Central Line: Silicone is Safer! | Polyurethane versus silicone port a cath (PAC): What's going on at removal? | Alzahrani et al. | Journal of Pediatric Surgery | 216 central lines were removed | Polyurethane group (119) | 11 fractures | Silicone group (86) | No fractures | *The risk of fracture significantly related to the duration of the line after 2 years | Polyurethane-based catheters are more vulnerable to rupture and retained fragment in the blood vessels. | Use silicone-based catheter and remove it within 2 years. | The visual abstract created by Abdulraouf Lamoshi and Todd Ponsky

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