Catheter tangled in blood vessels

The Hidden Risks of Long-Term Catheter Use: What You Need to Know

Soraya Malik in Health & Wellness June 2025 • 3 min read.

"While permanent catheters offer convenience, a less-known complication—the 'stuck catheter'—can lead to serious health issues. Learn how to prevent and manage this hazardous twist."

In nephrology, ensuring a well-functioning vascular access is critical. Catheters have become more common with the rise in dialysis prevalence, offering a solution for those with conditions that prevent arteriovenous (AV) access. These conditions include peripheral vascular disease, congestive heart failure, AV-access aneurysms, vascular steal phenomenon, and exhausted vascular access sites.

Tunneled catheters are often favored for their ease of use and convenience, but this preference comes with increased risks. Complications and the need for catheter removal are significant concerns. One such complication is the 'stuck catheter,' where the catheter adheres to the vessel wall, requiring invasive interventions for removal.

This article explores the 'stuck catheter' phenomenon and its consequences, drawing on a retrospective review of tunneled hemodialysis catheters. Understanding this complication can help improve patient care and outcomes.

What is a 'Stuck Catheter' and Why is it a Problem?

A 'stuck catheter' occurs when a tunneled catheter resists removal due to adherence to the vessel wall. Normally, a catheter should slide out smoothly after the fibrous sheath is dissected from the surrounding cuff. However, in rare cases, the catheter becomes tethered, necessitating more aggressive interventions.

These interventions can include direct exploration, endoluminal procedures by interventional radiology (IR), or even open surgical measures like thoracotomy. Such procedures are associated with significant morbidity. While catheters are commonly known as 'permcaths,' it's essential to recognize the potential complications of catheter adhesion and retention.

Infection Risk: Stuck catheters can increase the risk of infections, potentially leading to severe complications.
Vascular Damage: Aggressive removal attempts can damage the vessel wall, causing further complications.
Increased Morbidity: Surgical interventions to remove stuck catheters are associated with higher morbidity rates.
Loss of Access: The affected vascular access site may become unusable for future catheter placements.

To understand the occurrence and consequences of this issue, a retrospective review was conducted. The goal was to describe the occurrence of this 'stuck catheter' phenomenon and its consequences.

How to Prevent and Manage Stuck Catheters

While retention of tunneled central venous catheters is rare, it is an important complication of prolonged catheter use. Nephrologists should be aware of this complication and its subsequent management. Endoluminal balloon dilatation procedures can be the initial approach to address the issue. In patients who fail less invasive endovascular procedures and are considered at high surgical risk, embedding the catheter after ligation and proximal division of the ports is an option with subsequent surveillance for and timely management of complications, such as sepsis.

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This article is based on research published under:

DOI-LINK: 10.5301/jva.5000392, Alternate LINK

Title: The Stuck Catheter: A Hazardous Twist To The Meaning Of Permanent Catheters

Subject: Nephrology

Journal: The Journal of Vascular Access

Publisher: SAGE Publications

Authors: Venkat Sainaresh Vellanki, Diane Watson, Dheeraj K. Rajan, Cynthia B. Bhola, Charmaine E. Lok

Published: 2015-04-28

Everything You Need To Know

What exactly is a 'stuck catheter'?

A 'stuck catheter' is a serious complication that occurs when a tunneled catheter adheres to the vessel wall, preventing its easy removal. Unlike normal situations where the catheter can be smoothly removed after the fibrous sheath is dissected, a 'stuck catheter' requires more invasive interventions, such as direct exploration, endoluminal procedures, or even open surgical measures like thoracotomy.

Why is a 'stuck catheter' a problem?

The significance of a 'stuck catheter' lies in the complications it can cause. The aggressive interventions required for its removal are associated with significant morbidity. These complications include increased infection risk, vascular damage, higher morbidity rates, and potential loss of vascular access. The risk of a 'stuck catheter' is a crucial consideration when evaluating the long-term use of tunneled catheters, particularly in nephrology settings where vascular access is critical for dialysis.

Why are tunneled catheters used?

Long-term catheter use, especially involving tunneled catheters, is more common with the rise in dialysis prevalence. These are often favored for their ease of use in patients with conditions that prevent arteriovenous (AV) access, such as peripheral vascular disease, congestive heart failure, AV-access aneurysms, vascular steal phenomenon, and exhausted vascular access sites. However, the convenience comes with increased risks, with 'stuck catheter' being a notable and dangerous complication.

What can be done to prevent or manage 'stuck catheters'?

Preventing and managing 'stuck catheters' involves several strategies. Nephrologists should be aware of this complication. Initial approaches often include endoluminal balloon dilatation procedures. For patients who fail less invasive procedures and are at high surgical risk, embedding the catheter after ligation and proximal division of the ports is an option. Continuous surveillance and timely management of potential complications, especially sepsis, are also essential in managing 'stuck catheters'.

What are the implications of a 'stuck catheter'?

The implications of a 'stuck catheter' are considerable, impacting patient care and outcomes. The need for invasive procedures to remove the catheter contributes to increased morbidity, including infection risk, vascular damage, and potential loss of vascular access. This can lead to prolonged hospital stays, increased healthcare costs, and potentially life-threatening complications. Understanding and addressing the 'stuck catheter' phenomenon is crucial for improving patient safety and optimizing the management of tunneled catheters, especially in the context of dialysis.