In Reply to: 597 04 -- Catheter-related SVC thrombosis posted by Editor on May 15, 1997 at 17:01:43:
We have had fairly limited success with stripping and generally just change the catheter although in this case I agree that you would need to try to lyse the large mass of clot first otherwise the new catheter would be at risk for early occlusion. One of the earlier comments indicated that they change catheters if they are of the non-tunneled variety. We have found that you can also change many of the tunneled catheters over a guidewire if the catheter has been in long enough to form some kind of peri-catheter tract. Generally, I use a stiff shaft Teurmo wire for this maneuver since the stiffness aids passage of the new catheter but the hydrophilic coating helps the wire take the curves.