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D/c'ing CVC, with related thrombus

At our hospital, we remove the majority of non-tunneled CVC's.

It has been our practice to ask an MD to d/c a CVC if there is a thrombus in that vessel, on the catheter, or in a nearby related vessel.  I've had a couple of physicians (who didn't want to have to d/c them, or were unfamiliar with CVC d/c in one case) who wanted to know why. 

I would like to find guidelines and research about the issue of embolization during d/c of catheters - for my/my patient's benefit, and for our facility.  I'm sure we've d/c'd CVC's that had thrombi on them or nearby, without knowing it.  Unless the MD preferred to leave the catheter dwelling during anti-coagulation rx, what different techniques for d/c'ing such catheter would be used, if any, for a line with related thrombus?

Anyone have suggestions? 

Mari Cordes RN

IV Therapy Team

Fletcher Allen Health Care  Burlington, VT

There are no established

There are no established recommendations about the best method for treating a catheter related thrombosis. Not all cause a PE but this is a distinct possibility. There is no difference in the process for removal with our without a  CRT.  In fact, you have probably pull  many catheters that have a CRT and just did not know it. If there is  signs and symptoms of PE, then you must be prepared to appropriately intervene. 

Catheter-directed thrombolysis is probably one of the best methods for treating CRT. Lynn 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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