In Reply to: Re: 597 04 -- Catheter-related SVC thrombosis posted by dgolwynjr on June 16, 1997 at 18:23:26:
We've been exchanging tunneled permacaths since 1995 and have rarely encountered one we couldn't replace. Removing the adherent tissue from the cuff can be difficult but rather than bluntly dissecting it with forceps i use gauze or a peanut on a pair of hemostats and 90% of the time it comes off in about 15 seconds. Only once have I had one that required a lot of manipulation. As far as the exchange, deep placement of a super stiff glide is important and occasionallly we've had to get real creative with peelaways and pushing on the tube from the skin surface to help it negotiate the curve.