Time to Hemostasis after Traction Removal of Tunneled Cuffed Central Venous Catheters

Michael S. Stecker, Matthew S. Johnson, Jun Ying, Gordon McLennan, David M. Agarwal, Jan Namyslowski, Iftikhar Ahmad, Himanshu Shah, Sabah Butty, Thomas Casciani

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: Many patients undergo placement of tunneled cuffed central venous catheters (TCCVCs) for indications including administration of medical therapy and hemodialysis. They are removed when no longer needed or if there is a device complication. There is no consensus regarding the necessity of routine preremoval coagulation studies or platelet count, so this study was performed to determine if abnormal coagulation status affects the time to hemostasis (TH) after traction removal of TCCVCs. Materials and Methods: Adult patients referred to our group for removal of a TCCVC placed via a jugular or subclavian route were considered candidates for inclusion. Blood was submitted for evaluation of prothrombin time (PT) and International Normalized Ratio (INR), activated partial thromboplastin time (aPTT), and platelet count. Catheters were removed with the traction technique, and presence of hemostasis was assessed at 5-minute intervals of manual compression. Results: Between November 19, 2001, and April 20, 2004, 179 subjects were enrolled and completed the study. There were 165 subjects in whom TH was within the first 5-minute interval and 14 in whom more than 5 minutes was required. Statistically significant factors associated with prolonged TH were primary diagnosis of end-stage renal disease (P = .005), use of antiplatelet agents (P = .03), and procedure performed by a "low-volume" operator (P = .002). Conclusions: Routine preremoval evaluation of coagulation parameters is not necessary. Patients who are likely to have abnormal platelet function but not abnormal platelet number appear to be at risk for prolonged TH, but even in those cases, the THs are rarely more than 15 minutes.

Original languageEnglish
Pages (from-to)1232-1239
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume18
Issue number10
DOIs
StatePublished - Oct 2007

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Central Venous Catheters
Traction
Hemostasis
Platelet Count
International Normalized Ratio
Partial Thromboplastin Time
Platelet Aggregation Inhibitors
Prothrombin Time
Chronic Kidney Failure
Renal Dialysis
Neck
Blood Platelets
Catheters
Equipment and Supplies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Time to Hemostasis after Traction Removal of Tunneled Cuffed Central Venous Catheters. / Stecker, Michael S.; Johnson, Matthew S.; Ying, Jun; McLennan, Gordon; Agarwal, David M.; Namyslowski, Jan; Ahmad, Iftikhar; Shah, Himanshu; Butty, Sabah; Casciani, Thomas.

In: Journal of Vascular and Interventional Radiology, Vol. 18, No. 10, 10.2007, p. 1232-1239.

Research output: Contribution to journalArticle

Stecker, MS, Johnson, MS, Ying, J, McLennan, G, Agarwal, DM, Namyslowski, J, Ahmad, I, Shah, H, Butty, S & Casciani, T 2007, 'Time to Hemostasis after Traction Removal of Tunneled Cuffed Central Venous Catheters', Journal of Vascular and Interventional Radiology, vol. 18, no. 10, pp. 1232-1239. https://doi.org/10.1016/j.jvir.2007.06.035
Stecker, Michael S. ; Johnson, Matthew S. ; Ying, Jun ; McLennan, Gordon ; Agarwal, David M. ; Namyslowski, Jan ; Ahmad, Iftikhar ; Shah, Himanshu ; Butty, Sabah ; Casciani, Thomas. / Time to Hemostasis after Traction Removal of Tunneled Cuffed Central Venous Catheters. In: Journal of Vascular and Interventional Radiology. 2007 ; Vol. 18, No. 10. pp. 1232-1239.
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AU - Johnson, Matthew S.

AU - Ying, Jun

AU - McLennan, Gordon

AU - Agarwal, David M.

AU - Namyslowski, Jan

AU - Ahmad, Iftikhar

AU - Shah, Himanshu

AU - Butty, Sabah

AU - Casciani, Thomas

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N2 - Purpose: Many patients undergo placement of tunneled cuffed central venous catheters (TCCVCs) for indications including administration of medical therapy and hemodialysis. They are removed when no longer needed or if there is a device complication. There is no consensus regarding the necessity of routine preremoval coagulation studies or platelet count, so this study was performed to determine if abnormal coagulation status affects the time to hemostasis (TH) after traction removal of TCCVCs. Materials and Methods: Adult patients referred to our group for removal of a TCCVC placed via a jugular or subclavian route were considered candidates for inclusion. Blood was submitted for evaluation of prothrombin time (PT) and International Normalized Ratio (INR), activated partial thromboplastin time (aPTT), and platelet count. Catheters were removed with the traction technique, and presence of hemostasis was assessed at 5-minute intervals of manual compression. Results: Between November 19, 2001, and April 20, 2004, 179 subjects were enrolled and completed the study. There were 165 subjects in whom TH was within the first 5-minute interval and 14 in whom more than 5 minutes was required. Statistically significant factors associated with prolonged TH were primary diagnosis of end-stage renal disease (P = .005), use of antiplatelet agents (P = .03), and procedure performed by a "low-volume" operator (P = .002). Conclusions: Routine preremoval evaluation of coagulation parameters is not necessary. Patients who are likely to have abnormal platelet function but not abnormal platelet number appear to be at risk for prolonged TH, but even in those cases, the THs are rarely more than 15 minutes.

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