StayCurrentMD · Management of Retained Central Venous Catheters
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Video3 min·Published Apr 2019Older

Management of Retained Central Venous Catheters

With Dr. Ian Glenn · StayCurrentMD
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What the experts said13 expert statements · 2 host summaries
5 to 15% of patients who have catheters removed require some sort of additional intervention to remove the catheter.
EpidemiologicalIan Glenn
The actual number of catheters or catheter fragments that get left behind is 0.2 to 2%.
EpidemiologicalIan Glenn
Risk factors for catheter retention include chemotherapy infusion through the line.
ClinicalIan Glenn
Risk factors for catheter retention include catheters that are indwelling for longer than about a year and a half.
ClinicalIan Glenn
There is an association between polyurethane catheter material and catheter retention when compared with silicone catheters.
ClinicalIan Glenn
Power ports are polyurethane catheters.
Clinical
The recommendation would be to go with silastic catheters for long-term chemotherapy cases.
GuidelineIan Glenn
Surgical venotomy to retrieve a retained catheter carries a risk of bleeding.
ClinicalIan Glenn
In interventional radiology case series attempting endovascular catheter removal, there was a risk of the line completely breaking and embolizing distally.
ClinicalIan Glenn
In interventional radiology case series attempting endovascular catheter removal, there was a risk of thrombosis occurring during the procedure.
ClinicalIan Glenn
Multiple studies of patients with retained catheter fragments, with follow-up periods from months to the order of 5 years, found no complications.
EpidemiologicalIan Glenn
No thrombosis was associated with retained catheter fragments in studies with follow-up from months to 5 years.
EpidemiologicalIan Glenn
No infections were associated with retained catheter fragments in studies with follow-up from months to 5 years.
EpidemiologicalIan Glenn
Silastic lines generally have a larger size diameter for a given lumen compared to polyurethane lines.
Host summary
There has never been a report of a problem by leaving a retained catheter tip in, although long-term data are lacking.
Host summary