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Journal of Vascular Access 2001; 2: 64 - 67
Accidental migration of ASH-split catheter during central venous catheter replacement: retrieval using an interventional radiology approach
S. Galli1, A. Zollo1, F. Cavatorta1, P. Gazzo2


1Department of Nephrology and Dialysis, General Hospital, Imperia - Italy
2Radiology Service, General Hospital, Imperia - Italy
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S. Galli
A. Zollo
F. Cavatorta
P. Gazzo
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ABSTRACT
Catheter fracture and embolization of the distal fragment are well-known complications of subclavian central venous long-term cannulation. In hemodialysis it is an exceptional event. We report a case of accidental rupture of a cuffed hemodialysis catheter with distal migration of a fragment during a procedure of catheter exchange via guide-wire. According to most reported cases, intravascular catheter separation usually occurs completely asymptomatically; our report confirms that catheter embolization itself is usually asymptomatic. Less than one third of the literature-reported cases have associated symptoms, such as palpitations or chest discomfort. Once diagnosed, treatment is an interventional radiological approach, which has a very high success rate. The replacement of permanent cuffed hemodialysis catheters via guide-wire is a delicate procedure and if catheter embolization is diagnosed, the patient must be referred to a center with specific experience in the retrieval of intravascular objects. (The Journal of Vascular Access 2001; 2: 64-67)

Key Words. Central venous catheters, Catheter embolization, Complications

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REFERENCES



The Journal of Vascular Access - published and copyrighted by Wichtig Editore - Milano (Italy)
Autorizzazione n. 788 del 16.12.1999 reg. tribunale di Milano - Direttore Responsabile Diego Brancaccio - ISSN 1724-6032