1. Hickman catheter separation.
- Author
-
Rubenstein RB, Alberty RE, Michels LG, Pederson RW, and Rosenthal D
- Subjects
- Adult, Aged, Breast Neoplasms therapy, Embolism etiology, Equipment Failure, Female, Hodgkin Disease therapy, Humans, Lung Neoplasms therapy, Male, Middle Aged, Ovarian Neoplasms therapy, Testicular Neoplasms therapy, Uterine Cervical Neoplasms therapy, Uterine Neoplasms therapy, Catheterization instrumentation, Catheters, Indwelling
- Abstract
Seven patients with Hickman/Broviac catheters implanted via the percutaneous subclavian route are reported to have had catheter separation and embolization; one catheter implanted via cephalic vein cutdown also separated. The method of percutaneous subclavian catheter insertion is briefly described, and the mechanism of catheter separation is discussed. Percutaneous insertion routes the silicone catheter between the clavicle and first rib, producing compressive/shearing force which can cause the catheter to break--usually after several months. Embolized catheter fragments can be retrieved with a percutaneous transfemoral venous snare. The described complication represents a 1% incidence. Recommendations to minimize this problem include: placement of subclavian puncture at or lateral to midclavicular line; chest x-rays at 2- to 3-month intervals to identify catheter indentation at the thoracic inlet; early removal of catheters for patients with radiologic evidence of significant catheter compression. more...
- Published
- 1985
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