[Knot in a thoracic epidural catheter]

Abstract

We report a case of impossible injection into a thoracic epidural catheter associated with a difficult withdrawal of this catheter after its introduction on the T3-T4 level. Thanks to a gentle and continuous traction, the catheter was finally successfully removed without being broken, but presented a simple knot at 13mm from its end. No neurological complication was observed later on. This complication happened during the introduction of the catheter at the thoracic level where anatomic conditions are less favorable for this kind of complication to happen than at the lumbar level. We have been probably confronted with a catheter taking an abnormal direction due to an anatomic structure. This case shows us that knots in an epidural catheter are also possible on the high thoracic level and that its ascent within the epidural space must happen without any resistance.