title: Retained intravascular fragments after removal of indwelling central venous catheters: a single institution experience.
abstract: There are few reports regarding the presence of retained fixed fragments after removal of indwelling central venous catheters in children. We conducted a retrospective study of 355 patients who underwent removal of central venous catheter from 1996 to 2008. Six patients (1.6%) had a failed attempt of removal, resulting in a remnant of catheter left in the central venous system. All of them had underlying malignant disorders and received chemotherapy for a prolonged period of time. In 2 patients, a second attempt of retrieval was performed that was partially successful. After an average follow-up of 3.5 +/- 1.8 years, 1 patient has developed mild symptoms that could be related to the remaining fragment within the vascular system. Therefore, the incidence of complications caused by retained fixed fragments is low. Patients whose line has been in place for more than 48 months (P = 0.009) and those located in the saphenous vein (P = 0.01) are more prone to experience fragment retention. The decision of retrieval should be balanced according to the presence of symptoms and the length of the fragment retained.
authors.affiliation: Paediatric Oncology Unit, Hospital Infantil Universitario La Fe, Avenida de Campanar 21, 46009 Valencia, Spain. zekelindo@hotmail.com
authors.forename: Francisco
authors.initials: F
authors.lastname: Bautista
authors.forename: Javier
authors.initials: J
authors.lastname: Gómez-Chacón
authors.forename: Elisa
authors.initials: E
authors.lastname: Costa
authors.forename: Lucas
authors.initials: L
authors.lastname: Moreno
authors.forename: Adela
authors.initials: A
authors.lastname: Cañete
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Muro
authors.forename: Juan
authors.initials: J
authors.lastname: Velazquez
authors.forename: Victoria
authors.initials: V
authors.lastname: Castel
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D005547:Foreign Bodies / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012501:Saphenous Vein; D013030:Spain