Safe and simple reinsertion technique for occluded central venous catheter in premature infants

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Reoperation for a malfunctioning central venous catheter (CVC) is technically demanding as a bedside procedure in premature infants, and general anesthesia and paralysis is usually required for such an operation. Herein, we describe a safe and simple reinsertion technique to treat CVC occlusion using the original tract. Using a previous incision, the subcutaneous tract was identified, and the anterior half circle of the tract was opened. The catheter was transected through the opening, and the distal part was removed. A new catheter was introduced through an empty subcutaneous tunneling pathway and skin exit site, where the old distal part had been recently removed. Using fine 6–0 monofilament suture, traction sutures were placed along the cut edge of the proximal tract. The proximal part was then removed, and a newly placed catheter tip was inserted into the tract opening. When CVC reinsertion is required in premature infants, reinsertion can be accomplished easily and safely using this technique as a bedside procedure without general anesthesia.