title: The stuck catheter: a hazardous twist to the meaning of permanent catheters.
abstract: BACKGROUND
  Permanent central venous catheter use is associated with significant complications that often require their timely removal. An uncommon complication is resistant removal of the catheter due to adherence of the catheter to the vessel wall. This occasionally mandates invasive interventions for removal. The aim of this study is to describe the occurrence of this "stuck catheter" phenomenon and its consequences.
  
  
  METHODS
  A retrospective review of all the removed tunneled hemodialysis catheters from July 2005 to December 2014 at a single academic-based hemodialysis center to determine the incidence of stuck catheters. Data were retrieved from a prospectively maintained computerized vascular access database and verified manually against patient charts.
  
  
  RESULTS
  In our retrospective review of tunneled hemodialysis catheters spanning close to a decade, we found that 19 (0.92%) of catheters were retained, requiring endovascular intervention or open sternotomy. Of these, three could not be removed, with one patient succumbing to catheter-related infection. Longer catheter vintage appeared to be associated with 'stuck catheter'.
  
  
  CONCLUSIONS
  Retention of tunneled central venous catheters is a rare but important complication of prolonged tunneled catheter use that nephrologists should be aware of. Endoluminal balloon dilatation procedures are the initial approach, but surgical intervention may be necessary.
authors.affiliation: Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario - Canada.
authors.forename: Venkat Sainaresh
authors.initials: VS
authors.lastname: Vellanki
authors.forename: Diane
authors.initials: D
authors.lastname: Watson
authors.forename: Dheeraj K
authors.initials: DK
authors.lastname: Rajan
authors.forename: Cynthia B
authors.initials: CB
authors.lastname: Bhola
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000382:microbiology / Q000401:mortality; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D016208:Databases, Factual; D020878:Device Removal; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009864:Ontario; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy; D013997:Time Factors; D017211:Treatment Failure