Fundamental Technical Skills In Interventional Radiology: Removing IR Chest Tubes (Pigtail Catheters)

OVERVIEW

Once an IR placed chest tube is ready to be removed there are a number of ways that this task can be performed. The video below shows one technique. Of note the chest tube that is present in the video is a Cook Medical Dawson-Mueller Multipurpose Drainage Catheter (Order Number: G09706 REF: ULT10.2-38-25-P-5S-CLDM-HC).

It is important to realize that the removal of a chest tube may be informed by its design (which may change its locking mechanism). This page deals with removing a commonly used pigtail catheter that is often times used as an IR chest tube (image source).
WHAT EQUIPMENT TO GATHER BEFORE GOING TO PULL THE CHEST TUBE

Often times when one goes to perform a task they need to first make sure they bring all of the equipment that they may need with them for the task. Below is a list of what one would need to remove an IR chest tube (as well as links to example items):

  • Suture Removal Kit (Novaplus REF: 56639): this will be used to cut any anchoring sutures, and the scissors can also be used to cut the tube/cut the pigtail’s securing suture.
  • Clamp (Such As A Hemostat/Kelly Clamp): this can be used to clamp the tube to prevent aspiration of air through the lumen of the tube.
  • Xeroform Occlusive Gauze Strip (Covidien Ref 8884433605): this occlusive dressing is often times placed right over the tube exit site to prevent aspiration of air through the chest tube exit site in the skin.
  • 4×4 Or 2×2 Gauze (Dermacea USP Type VII Gauze, Covidien REF 442212): The size of the gauze may depend on the size of the exit site etc, however typically some type of gauze is placed over the xeroform to dress the chest tube exit site.
  • Tegarderm film (3M REF 1626W): the size of the tegarderm film will depend on the size of your dressing, but often times this is placed over the xeroform/gauze dressing to secure everything in place.
HOW TO REMOVE IR CHEST TUBES

The video below shows how to remove one type of commonly used IR chest tube. It is important to note that in this video the chest tube was not sutured in place. This is not always the case, make sure to cut any anchoring sutures before removing a chest tube! 

 

Page Updated: 03.24.2019