AUTHOR=Sławiński Grzegorz , Zieleniewicz Piotr , Faran Anna , Dąbrowska-Kugacka Alicja , Kurzyna Marcin , Kempa Maciej , Daniłowicz-Szymanowicz Ludmiła , Lewicka Ewa 

TITLE=Case report: Transected Hickman catheter and its thrombotic occlusion in a patient with idiopathic pulmonary arterial hypertension—can a catheter replacement be avoided?

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1230417

DOI=10.3389/fcvm.2023.1230417

ISSN=2297-055X

ABSTRACT=A 25-year-old female with idiopathic pulmonary arterial hypertension (PAH), who had a Hickman catheter implanted for continuous intravenous epoprostenol infusion, was admitted to the clinic after inadvertently cutting the catheter with nail scissors during a routine dressing change. Approximately 7 cm of the external segment of the Hickman catheter remained intact, with the distal end knotted by paramedics. A decision was made to repair the damaged Hickman catheter. However, it was discovered that its lumen was completely occluded by thrombosis.Therefore, catheter patency was mechanically restored using a 0.035-inch stiff guidewire in a sterile operating theatre setting, under fluoroscopy guidance. Successful aspiration and catheter flushing were achieved. Continuity of the Hickman catheter was then restored using a repair kit (Bard Access Systems) as per the manufacturer's instructions, with no visible leakage thereafter.Epoprostenol infusion through the Hickman catheter was resumed 24 hours later, and the patient was discharged in good general condition two days afterward.