Author:
Awan Muhammed Younas,Almatar Zahra,AlShawa Mohammad Anas,Alshanafey Saud
Abstract
Abstract
Background
Port-a-catheter insertion and removal are common procedures performed for children with chronic disease or cancer. Although its removal is usually straightforward, some difficulties during the procedure can be encountered. Several methods have been described in the literature to handle those cases where lines have become stuck.
Aim
To describe our simple technique in dealing with stuck port-a-catheters during removal. We will additionally report the incidence and factors associated with this complication.
Methods
A retrospective chart review study was performed between January 2009 and December 2019. Of a collective 2040 ports that were removed during the research interval, cases of difficult port removal were collected and reviewed. In 42 cases, catheter removal difficulty is encountered, and a second incision at the venous access site is performed. Failure of this procedure in removing the stuck catheter is then followed by catheter stenting and removal over a guide wire.
Results
Difficult removal of port-a-catheters was experienced in 42 cases (2%). The mean age at removal for those cases was 6.6 years. Most of the port-a-cath removals were done after treatment completion (74%). Ports had been left in situ for a mean duration of 44 months. The stepladder technique with wire stenting of the catheter was successful in 37 cases (88%), while the rest were only partially removed (distal part). The retained part was extracted using an angiographic technique. No short- or long-term complications were encountered in any of those 42 patients.
Conclusions
Stepladder with wire stenting of catheters approach deals with difficult line removals. Our technique is, therefore, simple, feasible, and effective.
Level of evidence
IV.
Publisher
Egypts Presidential Specialized Council for Education and Scientific Research
Subject
Pediatrics, Perinatology and Child Health,Surgery
Reference18 articles.
1. Wilson GJP, van Noesel MM, Hop WCJ, van de Ven C. The catheter is stuck: complications experienced during removal of a totally implantable venous access device. A single-center. 2006.
2. Wall JL, Kierstead VL. Peripherally inserted central catheters: resistance to removal: a rare complication. J IntravenNurs. 1995;18(5):251–4.
3. Bawazir O. Management of stuck long. 2018. https://doi.org/10.24327/ijcar.2018.15678.2870.
4. Bautista F, Gomez-Chacon J, Costa E, et al. Retained intravascular fragments after removal of indwelling central venous catheters: a single institution experience. J Pediatr Surg. 2010;45:1491–5. https://doi.org/10.1016/j.jpedsurg.2010.02.001.
5. Aworanti O, Linnane N, Tareen F, Mortell A. Incidence and outcome of retained port-a-cath fragments during removal. Pediatr Surg Int. 2017;33(7):777-781. https://doi.org/10.1007/s00383-017-4103-6.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献