The management of the difficult peripherally inserted central venous catheter line removal.

Difficulty with removing peripherally inserted central catheters is being encountered with increasing frequency. The most common cause of this phenomenon is venous spasm. Although gentle traction may overcome mild spasm, aggressive pulling is contraindicated. Methods and maneuvers to alleviate spasm are discussed, the simplest of which is to attempt catheter removal again after a short (20 to 30 minutes) or intermediate (12 to 24 hours) length of time, at which time spasm may have spontaneously abated.