title: Outcome of polyester cuff retention following traction removal of tunneled central venous catheters.
abstract: OBJECTIVE
  To elucidate the factors that contribute to cuff retention during traction removal of tunneled catheters, as well as to determine the risk of complication associated with polyester cuff retention.
  
  
  METHODS
  A total of 428 tunneled, cuffed catheters were removed with traction and local anesthesia. Polyester cuff retention was recorded when it occurred, and the effects of cuff retention were determined at a mean follow-up of 250 days. Statistical analysis was performed to determine the variables influencing cuff retention.
  
  
  RESULTS
  Traction removal was successful in 428 (100%) patients. Of 428 catheters removed, 41 (10%) cuffs were retained. Silicone 10-F double-lumen and 9.6-F single-lumen catheters had a higher rate of cuff retention (27 [32%] of 84 and nine [39%] of 23, respectively) than did the split-tip polyurethane hemodialysis catheter (two [1%] of 196; P <.001). Cuff retention rates among other catheter types compared with that of the polyurethane catheter were not significantly different. Duration of catheter dwell did not significantly influence cuff retention. Of 41 retained cuffs, three required removal with cutdown for cuff migration to the exit site, which inhibited healing (n = 1); for suspected infection (n = 1); or for cosmetic purposes as requested by the patient (n = 1). The remaining patients had no complications associated with cuff retention.
  
  
  CONCLUSIONS
  Traction removal of smaller-bore silicone catheters is more likely to result in cuff retention than removal of larger silicone and polyurethane catheters, and cuff retention is usually inconsequential.
authors.affiliation: Department of Radiology, Indiana University School of Medicine, University Hospital, Rm 0279, 550 N University Blvd, Indianapolis, IN 46202-5253, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Kohli
authors.forename: S O
authors.initials: SO
authors.lastname: Trerotola
authors.forename: J
authors.initials: J
authors.lastname: Namyslowski
authors.forename: M S
authors.initials: MS
authors.lastname: Stecker
authors.forename: G
authors.initials: G
authors.lastname: McLennan
authors.forename: N H
authors.initials: NH
authors.lastname: Patel
authors.forename: M S
authors.initials: MS
authors.lastname: Johnson
authors.forename: H
authors.initials: H
authors.lastname: Shah
authors.forename: R
authors.initials: R
authors.lastname: Seshadri
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D020878:Device Removal; D005260:Female; D005547:Foreign Bodies / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D011091:Polyesters; D011446:Prospective Studies; D014143:Traction
chemical_list: D011091:Polyesters