Chapter 1 of 4 · Fundamentals
Incidence rates
Case presentation and incidence of catheter retention
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What the experts said
5 to 15% of patients who have catheters removed require some sort of additional intervention to remove the catheter.
The actual number of catheters or catheter fragments that get left behind is 0.2 to 2%.
Risk factors for catheter retention include chemotherapy infusion through the line.
Risk factors for catheter retention include catheters that are indwelling for longer than about a year and a half.
There is an association between polyurethane catheter material and catheter retention when compared with silicone catheters.
Power ports are polyurethane catheters.
The recommendation would be to go with silastic catheters for long-term chemotherapy cases.
Surgical venotomy to retrieve a retained catheter carries a risk of bleeding.
In interventional radiology case series attempting endovascular catheter removal, there was a risk of the line completely breaking and embolizing distally.
In interventional radiology case series attempting endovascular catheter removal, there was a risk of thrombosis occurring during the procedure.
Multiple studies of patients with retained catheter fragments, with follow-up periods from months to the order of 5 years, found no complications.
No thrombosis was associated with retained catheter fragments in studies with follow-up from months to 5 years.
No infections were associated with retained catheter fragments in studies with follow-up from months to 5 years.
Silastic lines generally have a larger size diameter for a given lumen compared to polyurethane lines.
There has never been a report of a problem by leaving a retained catheter tip in, although long-term data are lacking.