Bard Access Systems, Inc.
17
Catheter Removal
After tissue grows into the SureCuff* Tissue Ingrowth Cuff (2 to 3 weeks),
catheters can be removed from the subcutaneous tunnel using one of
several methods. The method used will depend upon physician preference
and the amount of tissue/cuff ingrowth that is present. The catheter can
usually be removed by traction on the external segment (see #1 below) if it
is not sutured internally at the cuff or vessel insertion site. Surgical removal
(see #2 below) may be necessary to prevent breaking the catheter if the
catheter does not dislodge easily with traction or if there is no definite
suture site information.
Warning: You should not feel any resistance when withdrawing the
catheter from the vein. If you do encounter resistance, this may
indicate that the catheter is being pinched between the clavicle
and first rib (the “pinch-off” sign). Do not continue pulling against
resistance as this may cause catheter breakage and embolism. Free up
the resistance (e.g. by repositioning the patient) before proceeding
further.
1. Traction Removal
Pull the catheter external segment downward in a straight line away
from the exit site with a series of gentle tugs. When separation of the
cuff from the surrounding tissue and/or catheter occurs, there will
be a “break-away” feeling. Continue to pull gently on the catheter
to complete the removal. Apply pressure to the catheter/vein
insertion site as needed to control bleeding. If the cuff remains in the
subcutaneous tissue, dissect it out through a small incision utilizing
local anesthesia.
2.
Surgical Removal (using aseptic technique)
a. Locate the position of the cuff either by palpation or by
observing the position of “dimpling” when traction is applied to
the catheter’s external segment.
b. Make a short transverse incision at or below the external side of
the cuff taking care not to transect the catheter. Reach under the
catheter with a curved, smooth-jawed clamp and pull up on the
catheter to remove the catheter tip from the vein.
