Temporary Repair Prior to Permanent Repair of Silicone Tunneled Central Venous Catheters in Intestinal Failure Patients

Highlights

• Repairing central venous catheters is critical for pediatric patients with chronic vascular access needs.

• Depending on the mechanism of the break, a tunneled catheter may also present with intraluminal thrombotic occlusions.

• If intraluminal central venous catheter occlusion is not recognized at the time of permanent repair, central venous catheter functionality may not be restored, resulting in further delays in delivering intravenous support, other unscheduled care visits, or longer hospitalization.

• By ensuring restoration of patency prior to permanent repair, the likelihood of successful repair can be increased.

Abstract

Repeated central venous catheter (CVC) replacement is costly, invasive, requires sedation, and can contribute to loss of a vascular access. It is therefore prudent to attempt to salvage damaged CVCs through repair when possible. Identifying potential etiologies for CVC damage, such as CVC occlusion, is critical, as failure to do so would likely result in unsuccessful repair and further interventions, including CVC exchange/replacement. By introducing the step of a temporary repair, the clinician has the advantage of recognizing the presence of intraluminal CVC occlusion and addressing that through thrombolytic therapy. Once patency in achieved, a permanent repair can be performed.