A complication associated with central line removal in the pediatric population: Retained fixed catheter fragments

Background: There are many reports on the complications that occur at the time of insertion and during the life of central venous indwelling catheters. However, there is no literature that describes the complications that occur at the time of removal of these lines. Methods: A retrospective review of 136 central line (Broviacs [B], Port-A-Caths [PC] and Hickmans [HC]) removals during the last 5 years was undertaken. Results: A total of 97% were removed after completion of chemotherapy, and 3% because of sepsis or malfunction. Three PC lines broke at the time of removal resulting in a length of line remaining in the central venous system (the superior vena cava, innominate vein, and bracheo-cephalic subclavian junction). Two lines were inserted by a cut-down technique into the external jugular and one line by the percutaneous technique into the subclavian vein. At follow-up, none of the residual lines were associated with thrombus formation, and none showed any evidence of migration. Conclusions: This review identifies a specific problem that can occur with central line removal. Both the long-term affects of residual catheter within the central venous system and the need to remove the foreign body have yet to be addressed.