Name of the Procedure:

Removal of Tunneled Central Venous Catheter, without Subcutaneous Port or Pump
Common name(s): Catheter removal, Central line removal

Summary

This procedure involves the removal of a tunneled central venous catheter, which is a long, flexible tube inserted into a large vein in the chest or neck to administer medication, fluids, or draw blood. The catheter is tunneled under the skin but does not include an attached port or pump.

Purpose

The primary purpose of this procedure is to remove a central venous catheter that is no longer needed, has become infected, or is malfunctioning. It aims to prevent infection and other complications associated with leaving an unnecessary catheter in place.

Indications

• Infection at the catheter site
• Catheter malfunction or blockage
• Completion of treatment requiring the catheter
• Catheter displacement
• Persistent pain or discomfort at the catheter site

Preparation

• Fasting is usually not required.
• Patients should inform their healthcare provider of all medications they are taking.
• Blood tests may be required to check for clotting ability.
• Follow specific instructions provided by the healthcare team, such as arriving with clean skin and bringing someone to drive you home.

Procedure Description

1. The patient is positioned comfortably, often lying flat.
2. The area around the catheter is cleaned and sterilized.
3. Local anesthetic is applied to numb the area.
4. The sutures (stitches) holding the catheter in place are removed.
5. The catheter is then gently pulled out.
6. Pressure is applied to the site to prevent bleeding, and a sterile dressing is placed over the area.

Duration

The procedure typically takes about 30 minutes.

Setting

It is usually performed in an outpatient clinic, hospital procedure room, or sometimes at the bedside in a hospital setting.

Personnel

• Interventional radiologist or surgeon
• Nurse or medical assistant
• Occasionally, an anesthesiologist for additional sedation if necessary

Risks and Complications

• Bleeding or bruising at the removal site
• Infection
• Pain or discomfort
• Rarely, damage to blood vessels or surrounding tissues
• Air embolism, although extremely rare

Benefits

• Reduced risk of infection and catheter-related complications
• Improved comfort and mobility once the catheter is removed
• Immediate removal of an unnecessary or malfunctioning device

Recovery

• Keep the removal site clean and dry.
• Follow any additional instructions provided by your healthcare team.
• Watch for signs of infection such as redness, swelling, or pus.
• Generally, recovery is quick, and normal activities can be resumed within a day or two.

Alternatives

• Leaving the catheter in place with continued monitoring
• Inserting a new catheter if ongoing central access is needed
• Weighing the pros and cons of each alternative with your healthcare provider

Patient Experience

During the procedure, the patient might feel pressure but should not feel pain due to the numbing anesthetic. After the removal, there may be mild discomfort or tenderness at the site. Pain management will be minimal, often controlled with over-the-counter pain relievers. Most patients can return to usual activities shortly after the procedure, with specific post-care instructions to ensure proper healing.