Abstract
Purpose
To determine the efficacy of the transfemoral vein approach to repositioning malpositioned central venous catheters.
Methods
During a 41/2-year period, malpositioned central venous catheters were repositioned 91 times in 83 patients via the transfemoral vein approach. All repositioning was initially attempted with a Grollman catheter or other pigtail catheter and a tip-deflecting wire. If these techniques failed or the venous anatomy was unfavorable, gooseneck or long loop snares were used.
Results
During 48 repositionings, rotating a pigtailtype catheter alone was used successfully in 39 (81%). In 6 of 9 failures, the addition of a tip-deflecting wire also failed. A Grollman catheter and tip-deflecting wire were used initially in 39 repositionings (6 failures; 85% success). Successful repositioning required a snare in 8 (4 as the primary repositioning technique) and a longloop technique in 5. All repositionings were ultimately successful and there were no complications.
Conclusion
Central venous catheters can be repositioned consistently by the transfemoral route. Pigtail catheters or tip-deflecting wires alone are successful in over 80% of cases.
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Gordon Hartnell, G., Gates, J., Suojanen, J.N. et al. Transfemoral repositioning of malpositioned central venous catheters. Cardiovasc Intervent Radiol 19, 329–331 (1996). https://doi.org/10.1007/BF02570184
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DOI: https://doi.org/10.1007/BF02570184