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Fractured Indwelling Pleural CathetersFractured Indwelling Pleural Catheters

Edward T. H. Fysh, MBBS; John M. Wrightson, MBBChir; Y. C. Gary Lee, MBChB, PhD, FCCP; Najib M. Rahman, DPhil
Author and Funding Information

From the Centre for Asthma, Allergy, and Respiratory Research (Drs Fysh and Lee), School of Medicine and Pharmacology, University of Western Australia, and Department of Respiratory Medicine (Drs Fysh and Lee), Sir Charles Gairdner Hospital, Perth, WA, Australia; and Oxford Centre for Respiratory Medicine (Drs Wrightson and Rahman), Churchill Hospital, and Oxford NIHR Biomedical Research Centre (Drs Wrightson and Rahman), University of Oxford, Oxford, England.

Correspondence to: Y. C. Gary Lee, MBChB, PhD, FCCP, University Department of Medicine, G Block, 4/F, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia; e-mail: gary.lee@uwa.edu.au


Funding/Support: The authors received research funding from the State Health Research Advisory Council of the Western Australian Health Department (to Dr Lee), the Sir Charles Gairdner Hospital project grants (to Drs Lee and Fysh), the Raine Foundation (to Dr Lee), the National Health Medical Research Council (to Drs Lee and Fysh), the University Postgraduate Award of the University of Western Australia (to Dr Fysh), the Oxford NIHR Biomedical Research Centre (to Drs Wrightson and Rahman), and the UK Medical Research Council (to Dr Rahman).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(4):1090-1094. doi:10.1378/chest.11-0724
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Indwelling pleural catheters (IPCs) are increasingly used in the management of malignant pleural effusions. IPCs are designed to be secured in situ indefinitely; however, in selected patients, IPCs can be removed when drainage ceases. This case series reports complications of removal of IPCs that resulted in fractured catheters or necessitated deliberate severing of the catheters. From the combined data of two pleural centers, 61 of 170 IPCs inserted (35.9%) were removed. In six cases (9.8%), the removals were complicated, leading to fracture or iatrogenic severing of the IPC. Although four patients had catheter fragments retained within the pleural space, none developed any complications (eg, pain or infection) (median follow-up, 459 days; range, 113-1,119 days), despite two patients undergoing subsequent chemotherapy. Clinicians should be aware that IPC removal can be problematic, but retained fragments are safe, and aggressive retrieval is unnecessary.

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