Difficult central venous access removal: case reports of the use of endovascular snare shearing of endothelialized tetherings

Teeple, Erin; Shiels, William E.; Nwomeh, Benedict C.; Rocourt, Dorothy V.; Caniano, Donna A.

doi:10.1016/j.jpedsurg.2011.01.029

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Indeed, guidelines and protocols regarding this procedure are lacking and, in most cases, management of CVC removal is considered a minor issue, thus performed according to physician's preference and experience (16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

A Dedicated Protocol and Environment for central venous Catheter removal in Pediatric Patients Affected by Onco-Hematological Diseases

et al. 2014

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Purpose The removal of long-term central venous catheters (CVCs) is not performed according to evidence-based guidelines, thus conveying the message that it is a procedure of secondary importance. Our study aims at comparing the experience at Bambino Gesù Pediatric Hospital before and after the implementation of a dedicated protocol and the identification of a specific area to perform such a procedure under the so-called nonoperating room anesthesia (NORA). Methods Starting on January 1, 2010, an appropriate protocol regarding long-term CVC removal was applied. Then, data from all patients who underwent CVC removal under NORA regimen were compared with patients who have undergone the same procedure before the beginning of such protocol in terms of complication rate, duration of procedure, and costs. Results Between January 2010 and December 2012, 266 patients were evaluated for long-term CVC removal under a NORA regimen. Of these, 194 underwent the procedure. In the period from January 2007 to December 2009, 60 out of 82 patients scheduled for elective removal of long-term CVC in the operating theatre were eligible for this study. Median procedure time was 7 min for removal in NORA and 10 min for the operating theatre (p=0.016); no complications occurred. Conclusion Long-term CVC removal is an often-neglected procedure, carrying a small, but definite rate of complications. Our study shows that CVC removal performed in NORA regimen is safe and feasible, also allowing multiple procedures in the same session with prompt management of possible complications and reduction of the anxiety and pain associated with the procedure.

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Section: Discussionmentioning

confidence: 99%

A Dedicated Protocol and Environment for central venous Catheter removal in Pediatric Patients Affected by Onco-Hematological Diseases

et al. 2014

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“…Quando oltre venticinque anni fa, i nefrologi hanno co-minciatoaposizionareiCVCp,siritenevaditrovarsidifronte adeidispositivicheavrebberopotutomigliorarel'accessodei pazientipiùanzianialladialisieconscarsopatrimoniovascolare. All'epoca sicuramente tra i vantaggi principali si intravedevanoquellodiottenereuntrattamentodialiticosenzail dolorelegatoallavenipuntura,quellodiottenereunaccesso vascolare che non necessitava di tempi di attesa per la sua maturazione,maalloranoneranoancorachiareleproblematicherecentementeriportate (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).Nelcorsodegliannigli inizialientusiasmisonostatifrenatidall'evidenzadiimportan-tieffetticollateralitracuicertamenteleinfezioniCVCcorrelate (15),ilmalfunzionamentoeunaumentodellamortalità non legata solo alle infezioni, ma insita allo stazionamento delCVCstesso (23,(24)(25)(26).Èstoriapiùrecentequelladell'aumentodeicosiddetti"stuckcatheters"ocateteriincarcerati oritenutioadesi,dicuituttelerealiimplicazioni,frequenza d'incidenzacompresa.nonsonoancoradeltuttonote.Idati dellaletteraturaacuivaadaggiungersiquestocasoclinico,ci ammoniscono a tener in debito conto anche questa importanteproblematica.…”

Section: Conclusioniunclassified

Un caso di Catetere Venoso Centrale ritenuto

Cornacchiari¹,

Toma²,

Stasi³

et al. 2017

G Clin Nefrol Dial

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“…A maggio2015dopocirca12mesilapazientecivieneinviatain regimediurgenza,perreiteratomalfunzionamentodelCVCp, nonostantenumerositentatividiripristinarnelafunzionalità mediantetrombolisiconl'urokinasi.Inrelazioneallasituazionediurgenza,alfattochelapazientenondializzavadaoltre72 ore,eallarelativa"breve"permanenzainsitudelCVCp,viene decisalasostituzionedellostesso.L'interventovieneeseguito insalachirurgica,inanestesialocale,lamanovrainiziaisolandolacuffiaindacron.Primaditagliareilcatetere,memoridei casiprecedentidiCVCpritenuto(1),sivalutalamobilitàdel CVCp,ilqualedopomodestatrazionefuoriescedi2-3cmsen-zaapparentidifficoltà.Pertantosiprocedeatagliareerimuoverelapartedistale(quellacomprendentelacuffia)equindi asfilareilsuotrattoprossimale.Allanuovatrazione,dopola fuoriuscitadicirca3-4cm,ilcatetereappareintrappolato.Una nuovaemaggioretrazioneprovocal'insorgeredidoloreretrosternaleepertantosiinterrompelamanovra...Siinformanoi parentidellaproblematicainsortaesponendoipossibilirischi connessiallediversemanovredirimozioneattuabili (4,(6)(7)(8)(9)(10)(11)(12)(13). Iparentineganoilconsensoaqualsiasimanovradirimozione delcatetere.…”

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