Outcome of polyester cuff retention following traction removal of tunneledcentral venous catheters

PURPOSE: To elucidate the factors that contribute to cuff retention during traction removal of tunneled catheters, as well as to determine the risk of complication associated with polyester cuff retention. MATERIALS AND METHODS: A total of 428 tunneled, cuffed catheters were remov ed with traction:and local anesthesia. Polyester cuff retention was recorde d when it occurred, and the effects of cuff retention were determined at a mean follow-up of 250 days. Statistical analysis was performed to determine the variables influencing cuff retention. RESULTS: Traction removal was successful in 428 (100%) patients. Of 428 cat heters removed, 41 (10%) cuffs were retained. Silicone 10-F double-lumen an d 9.6-F single-lumen catheters had a higher rate of cuff retention (27 [32% ] of 84 and nine [39%] of 23, respectively) than did the split-tip polyuret hane hemodialysis catheter (two [1%] of 196; P < .001). Cuff retention rate s among other catheter types compared with that of the polyurethane cathete r were not significantly different. Duration of catheter dwell did not sign ificantly influence cuff retention. Of 41 retained cuffs, three required re moval with cutdown for cuff migration to the exit site, which inhibited hea ling (n = 1); for suspected infection (n = 1); or for cosmetic purposes as requested by the patient (n = 1). The remaining patients had no complicatio ns associated with cuff retention. CONCLUSION: Traction removal of smaller-bore silicone catheters is more lik ely to result in cuff retention than removal of larger silicons and polyure thane catheters, and cuff retention is usually inconsequential.