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, Sir Charles Gairdner Hospital (Drs Fysh and Lee); and Oxford Centre for Respiratory Medicine (Drs Wrightson and Rahman), Churchill Hospital, and Oxford Biomedical Research Centre (Drs Wrightson and Rahman), University of Oxford.
Correspondence to: Y. C. Gary Lee, MBChB, PhD, FCCP, University Department of Medicine, G Block, 4/F, Sir Charles Gairdner Hospital, Hospital Ave, Perth, WA, 6009, Australia; e-mail: firstname.lastname@example.org
Funding/Support: The authors received research funding from the State Health Research Advisory Council of the Western Australian Health Dept (to Dr Lee), the Sir Charles Gairdner Hospital project grants (to Drs Fysh and Lee), the Raine Foundation (to Dr Lee), National Health Medical Research Council (to Drs Fysh and Lee), 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).
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Drs Lee and Rahman are investigators for the TIME-2 study funded by the British Lung Foundation. The indwelling pleural catheters used in the study were provided without charge by Rocket Medical plc. None of the investigators received personal benefits from the study. Dr Lee has received an honorarium from CareFusion Corp. Dr Rahman has provided consultancy services for Rocket Medical plc. Drs Fysh and Wrightson have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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We thank Dr Grosu and colleagues for their comments on and interest in our study1 in CHEST. We would like to clarify some important points.
1. Fractures occurred in four of 61 attempted removals of catheters (6.6%) from our series of 170 patients in total. The incidence of fracture of the overall cohort was, therefore, 2.4%.
2. The incidence of 2.4% would naturally include a degree of selection bias as only centers with experience in the reported complication were included in these statistics.
3. The key message of our article was not to report the incidence of this complication. Rather, it was to show that when this rare complication does occur there is no need to undertake aggressive methods of retrieving the retained portion. Some of the patients even safely proceeded with chemotherapy with the retained portion of the catheter in situ.
Use of the indwelling pleural catheter continues to grow rapidly. Better understanding of the potential complications and their best management is critical to the successful use of these catheters.
Role of sponsors: The sponsors had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.
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