Name of the Procedure:

Repair of Tunneled or Non-Tunneled Central Venous Access Catheter, without Subcutaneous Port or Pump, Central or Peripheral Insertion Site

Summary

This procedure involves fixing a central venous access catheter that has been damaged or malfunctioned. The catheter is either tunneled or non-tunneled, but it does not include a subcutaneous port or pump. The catheter can be located at a central or peripheral insertion site on the body.

Purpose

The repair aims to restore the function of a central venous access catheter used to deliver medications, nutrients, or to draw blood. This is critical for patients requiring long-term intravenous (IV) therapy or frequent blood sampling.

Indications

• Malfunctioning or damaged central venous catheter
• Infection or clotting within the catheter
• Leakage or displacement of the catheter
• Complications during medication or fluid administration

Preparation

• Fasting may be required if sedation is needed.
• Adjustments to medications, particularly blood thinners.
• Blood tests and diagnostic imaging to assess the catheter and surrounding vessels.

Procedure Description

1. The patient is positioned and the insertion site is sterilized.
2. Local anesthesia or sedation may be administered.
3. The malfunctioning or damaged catheter is located through imaging if necessary.
4. The catheter repair is performed by either replacing a part of it or realigning it.
5. The site is sealed and dressed to prevent infection.

Tools/Equipment:

• Sterile drapes
• Catheter repair kits or replacement parts
• Imaging devices like ultrasound

Anesthesia/Sedation:

• Local anesthesia or sedation depending on patient needs and extent of repair.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the complexity of the repair.

Setting

• Hospital or outpatient clinic setting with access to medical imaging and sterile environment.

Personnel

• Interventional radiologist, vascular surgeon, or specialized nurse
• Assisting nurses or technical staff
• Anesthesiologist (if sedation or anesthesia is used)

Risks and Complications

• Infection at the insertion site
• Bleeding or bruising
• Damage to nearby blood vessels or tissues
• Catheter displacement or malfunction
• Allergic reaction to anesthesia
• Thrombosis (blood clots) in the vein

Benefits

• Restored function of the central venous access catheter
• Improved administration of medications and nutrients
• Reduced risk of complications from a faulty catheter
• Quick recovery, often resuming normal activities in a short period

Recovery

• Monitoring of the insertion site for infection or complications
• Keeping the area clean and dry
• Follow-up appointments for assessment and catheter function checks
• Instructions on how to care for the catheter site at home

Alternatives

• Complete replacement of the central venous access catheter
• Use of peripheral IV lines (less optimal for long-term therapy)
• Mediports or port-a-caths (implanted devices)

Pros and Cons:

• Alternatives may carry higher risks or require more complex surgery.
• Some alternatives provide longer-term solutions but might not be suitable for all patients.

Patient Experience

During the procedure, you may feel pressure or mild discomfort if local anesthesia is used. Sedation generally helps you relax or sleep lightly. Post-procedure, some soreness around the insertion site is common. Pain management strategies, including over-the-counter pain relief, can be discussed with your healthcare provider.