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Outcome of Polyester Cuff Retention Following Traction Removal of Tunneled Central Venous Catheters¹

¹ From the Departments of Radiology (M.D.K., S.O.T., J.N., M.S.S., G.M., N.H.P., M.S.J., H.S.) and Medicine, and the Division of Biostatistics (R.S.), Indiana University School of Medicine, University Hospital, Rm 0279, 550 N University Blvd, Indianapolis, IN 46202-5253. Received July 31, 2000; revision requested September 9; revision received October 3; accepted November 1. Supported by grants from Bard Access Systems, Salt Lake City, Utah, and Indiana University Radiology Associates, Indianapolis. Address correspondence to S.O.T. (e-mail: streroto@iupui.edu).

PURPOSE: To elucidate the factors that contribute to cuff retention during traction removal of tunneled catheters, as well as to determine the risk of complication associated with polyester cuff retention.

MATERIALS AND METHODS: A total of 428 tunneled, cuffed catheters were removed with traction and local anesthesia. Polyester cuff retention was recorded when it occurred, and the effects of cuff retention were determined at a mean follow-up of 250 days. Statistical analysis was performed to determine the variables influencing cuff retention.

RESULTS: Traction removal was successful in 428 (100%) patients. Of 428 catheters removed, 41 (10%) cuffs were retained. Silicone 10-F double-lumen and 9.6-F single-lumen catheters had a higher rate of cuff retention (27 [32%] of 84 and nine [39%] of 23, respectively) than did the split-tip polyurethane hemodialysis catheter (two [1%] of 196; P < .001). Cuff retention rates among other catheter types compared with that of the polyurethane catheter were not significantly different. Duration of catheter dwell did not significantly influence cuff retention. Of 41 retained cuffs, three required removal with cutdown for cuff migration to the exit site, which inhibited healing (n = 1); for suspected infection (n = 1); or for cosmetic purposes as requested by the patient (n = 1). The remaining patients had no complications associated with cuff retention.

CONCLUSION: Traction removal of smaller-bore silicone catheters is more likely to result in cuff retention than removal of larger silicone and polyurethane catheters, and cuff retention is usually inconsequential.

Index terms: Catheters and catheterization, central venous access • Catheters and catheterization, complications, 90.1269, 90.44 • Interventional procedures, complications, 90.1269, 90.44

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