Michalak Marcin, Januszkiewicz Łukasz, Majstrak Franciszek, Gawałko Monika, Opolski Grzegorz, Grabowski Marcin
1 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
2 1st Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland.
J Vasc Access. 2019 May;20(3):329-332. doi: 10.1177/1129729818792822. Epub 2018 Aug 30.
Long-term tunneled central venous catheters are widely used in several clinical indications, that is, hemodialysis, chemotherapy, and total parenteral nutrition. However, central venous catheters are associated with a number of complications, including catheter occlusion and sepsis, which may necessitate earlier catheter removal. In most cases manual traction is sufficient to remove the catheter. Nevertheless, in some cases severe adhesions, formed between the catheter and the vessel wall, complicate simple catheter removal. We present four cases of entrapped long-term central venous catheters and describe methods (e.g. endoluminal balloon dilatation and wire snare) performed by experienced cardiologists at high-volume center to remove them. We claim that permanent central venous catheters removal procedures may be unpredictable and hazardous. Therefore, entrapped central venous catheters should be extracted by experienced operators in specialized high-volume centers.
长期隧道式中心静脉导管广泛应用于多种临床情况，即血液透析、化疗和全胃肠外营养。然而，中心静脉导管会引发多种并发症，包括导管堵塞和败血症，这可能需要提前拔除导管。在大多数情况下，手动牵引足以拔除导管。然而，在某些情况下，导管与血管壁之间形成的严重粘连会使简单的导管拔除变得复杂。我们报告了4例长期中心静脉导管陷入的病例，并描述了由经验丰富的心脏病专家在大容量中心采用的拔除方法（如腔内球囊扩张和圈套器）。我们认为，永久性中心静脉导管拔除程序可能不可预测且具有危险性。因此，陷入的中心静脉导管应由专业大容量中心经验丰富的操作人员拔除。
