A multiinstitutional review of central venous line complications: retained intravascular fragments.
BACKGROUND
There have been many reports of complications of central venous lines in children but limited discussion of the specific problem of retained intravascular fragments after attempted removal. We report on a series of 6 patients from 2 tertiary pediatric hospitals that had intravascular segments of long-term central venous lines that could not be removed and so were left in situ.


METHODS
We conducted a retrospective multiinstitutional review of long-term central venous lines (Broviacs, Port-A-Caths, and Hickmans) removed in the operating room with a focused chart review and prospective follow-up of those patients that had a failed attempt at removal.


RESULTS
A total of 299 central venous lines were removed with 6 patients identified as having fragments of lines left behind (2%). The lines had been in place for an average of 37 +/- 12 months. The average follow-up period is now 5.4 +/- 3.9 years; none of the patients have developed any symptoms, evidence of thrombus, infection, or catheter migration.


CONCLUSIONS
Given the 2% incidence rate, the issue of managing a stuck long-term central venous line will face most individuals who place these lines. We have demonstrated that simply ligating the catheter and leaving the fragment in place appears to be a safe option with minimal risk to the patient.
Division of Paediatric General Surgery, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
Kris
K
Milbrandt
Paul
P
Beaudry
Ron
R
Anderson
Sarah
S
Jones
Mike
M
Giacomantonio
David
D
Sigalet
D002114:Calcinosis / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D007601:Jugular Veins; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012189:Retrospective Studies; D013350:Subclavian Vein