title: Occlusion of silastic broviac catheters as a result of twisting between the catheter and hub assembly.
abstract: Occlusion is a common cause of catheter malfunction during home parenteral nutrition (HPN). We report 5 cases of central venous catheter occlusion, encountered over a 24 month period, which were associated with twisting of the catheter at the hub assembly. One catheter was replaced before the cause of the occlusion was identified. In 4 cases, twisting was noted prior to catheter removal, and this was corrected in three, allowing HPN to continue without catheter replacement. In 1 case the catheter was repaired. The current design of silastic Broviac catheters allows the catheter to twist around the hub assembly. Over-enthusiastic tightening of the cap of the catheter leads to twisting which causes catheter occlusion. A high index of suspicion should be maintained when dealing with catheter occlusion associated with silastic Broviac catheters. Recognition of the problem allows catheter salvage without recourse to catheter replacement.
authors.affiliation: Department of Surgery, Hope Hospital, Eccles Old Road, Salford, M6 8HD, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Leinhardt
authors.forename: G L
authors.initials: GL
authors.lastname: Carlson
authors.forename: N
authors.initials: N
authors.lastname: Williams