Stuck tunneled central venous catheters in children: Four cases removed by angiography assistance

Özet

Adherent tunneled catheters can usually be removed by a surgical cut down,but in some cases the line can become stuck to the wall of the central veins.In such cases, forceful traction can cause vascular injury, or fracture of thecatheter. We present four cases of fixated cuffed tunneled catheters. Threechildren had acute lymphoblastic leukemia and one had an immunodeficiencysyndrome. All catheters were made from polyurethane. Indwelling times were12-24 months. All patients’ catheters were removed with great difficulty bytrans-femoral access. The angiography-assisted technique is safe and easilyapplied for the removal of stuck catheters in pediatric patients. These casesraise important questions concerning the maximum indwelling time andthe choice of catheter material when implanting permanent central venouscatheters (CVCs) in children.