Transfemoral repositioning of malpositioned central venous catheters.
OBJECTIVE
To determine the efficacy of the transfemoral vein approach to repositioning malpositioned central venous catheters.


METHODS
During a 4(1/2)-year period, malpositioned central venous catheters were repositioned 91 times in 83 patients via the transfemoral vein approach. All repositioning was initially attempted with a Grollman catheter or other pigtail catheter and a tip-deflecting wire. If these techniques failed or the venous anatomy was unfavorable, gooseneck or long loop snares were used.


RESULTS
During 48 repositionings, rotating a pigtail-type catheter alone was used successfully in 39 (81%). In 6 of 9 failures, the addition of a tip-deflecting wire also failed. A Grollman catheter and tip-deflecting wire were used initially in 39 repositionings (6 failures; 85% success). Successful repositioning required a snare in 8 (4 as the primary repositioning technique) and a long-loop technique in 5. All repositionings were ultimately successful and there were no complications.


CONCLUSIONS
Central venous catheters can be repositioned consistently by the transfemoral route. Pigtail catheters or tip-deflecting wires alone are successful in over 80% of cases.
Hartnell
G G
GG
Department of Radiological Sciences, Deaconess Hospital and Harvard Medical School, 1 Deaconess Road, Boston, MA 02215, USA.
Gates
J
J
Suojanen
J N
JN
Clouse
M E
ME
D002405:Catheterization, Central Venous / Q000295:instrumentation*; D004867:Equipment Design; D004868:Equipment Failure; D005268:Femoral Vein; D005471:Fluoroscopy; D006801:Humans; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012399:Rotation; D013499:Surface Properties