title: Tunneled infusion catheter breakage: frequency and repair kit outcomes.
abstract: OBJECTIVE
  To determine the frequency of tunneled infusion catheter breakage and the durability of a repair kit used to repair damage to the external catheter segment, avoiding catheter replacement.
  
  
  METHODS
  With use of a quality assurance database, 724 silicone tunneled infusion catheters placed between July 2002 and September 2005 were identified. The repair kit outcomes portion of the study focused on 10-F triple-lumen catheters (n = 433), the type placed most frequently in our practice and that with the most repairs available for analysis. To compare durability, nonrepaired catheters and those requiring repair were compared by using Cox proportion hazard regression.
  
  
  RESULTS
  Breakage occurred in 53 of 443 (12%) 10-F triple-lumen catheters, three of 64 (5%) 10-F dual-lumen catheters, four of 159 (3%) 11-F triple-lumen catheters, four of 12 (33%) 9.6-F single-lumen catheters, and eight of 56 (14%) 9-F double-lumen catheters. In the 10-F subset, the mean time to catheter breakage was 60 days. The mean catheter days for the nonrepaired group (143 days) and the repaired group (145 days) were not significantly different (chi2, 0.071; hazard ratio, 1.07; P = .79). Mean catheter dwell after repair was 79 days. The failure rate for the repair kit was 14% (seven of 51 attempts).
  
  
  CONCLUSIONS
  Tunneled infusion catheter breakage is common. Given the high breakage rates observed for many catheter designs, the development of more durable catheters should be a priority for catheter manufacturers. Until more durable catheters are developed, the catheter repair kit studied is an easy, effective, durable, and relatively inexpensive solution for the repair of external segment damage in tunneled infusion catheters.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104, USA.
authors.forename: Freeman R
authors.initials: FR
authors.lastname: Hwang
authors.forename: S William
authors.initials: SW
authors.lastname: Stavropoulos
authors.forename: Richard D
authors.initials: RD
authors.lastname: Shlansky-Goldberg
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Mondschein
authors.forename: Aalpen A
authors.initials: AA
authors.lastname: Patel
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Solomon
authors.forename: Maxim
authors.initials: M
authors.lastname: Itkin
authors.forename: Michael C
authors.initials: MC
authors.lastname: Soulen
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Chittams
authors.forename: Scott O
authors.initials: SO
authors.lastname: Trerotola
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D019544:Equipment Failure Analysis; D006801:Humans; D016016:Proportional Hazards Models; D012828:Silicones
chemical_list: D012828:Silicones