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Hickman Catheter Separation
Author(s) -
Rubenstein Richard B.,
Alberty Roger E.,
Michels Lee G.,
Pederson Robert W.,
Rosenthal David
Publication year - 1985
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607185009006754
Subject(s) - medicine , catheter , percutaneous , surgery , subclavian vein , clavicle , embolization , radiology , parenteral nutrition
Seven patients with Hickman/Broviac catheters implanted via the percutaneous subclavian route are reported to have had catheter separation and embolization; one catheter implanted via cephalic vein cutdown also separated. The method of percutaneous subclavian catheter insertion is briefly described, and the mechanism of catheter separation is discussed. Percutaneous insertion routes the silicone catheter between the clavicle and first rib, producing compressive/shearing force which can cause the catheter to break—usually after several months. Embolized catheter fragments can be retrieved with a percutaneous transfemoral venous snare. The described complication represents a 1% incidence. Recommendations to minimize this problem include: (1) placement of subclavian puncture at or lateral to midclavicular line; (2) chest x‐rays at 2‐ to 3‐month intervals to identify catheter indentation at the thoracic inlet; (3) early removal of catheters for patients with radiologic evidence of significant catheter compression. (Journal of Parenteral and Enteral Nutrition 9: 754–757, 1985)