PleurX catheter

PleurX is the brand name of a long-term drainage tube, also called a tunneled indwelling catheter. It is a thin, soft silicone tube. One end sits in the space where fluid builds up. The middle runs a few inches under the skin, in a short tunnel. The outer end comes out through the skin and is closed with a one-way valve, so nothing leaks between drainages.

A small cuff on the tube sits inside the tunnel. Over 2 to 3 weeks, the skin and tissue grow into the cuff. This anchors the tube and helps keep germs out. When you are not draining, the tube is coiled under a small dressing and most people forget it is there.

On a chest X-ray, the catheter shows up as a thin white line curving into the space around the lung. On ultrasound, the fluid looks black, which helps us pick a safe spot.

A PleurX catheter is for fluid that comes back again and again, usually within days to weeks after it is drained with a needle. The most common reason is cancer that affects the lining of the lung or the belly. It can also help some people with heart failure or liver disease when other treatments are no longer enough.

Needle drainage is a good choice when fluid returns slowly, for example every few weeks. When it returns in days, or when trips to the hospital are exhausting, a catheter often gives more control and comfort. For fluid around the lung, a third option is pleurodesis, a treatment that seals the lining so fluid cannot collect. See pleurodesis.

The catheter is placed as an outpatient procedure at El Camino Hospital, with numbing medicine and moderate sedation. We use ultrasound and X-ray to guide it. Placement usually takes 15 to 30 minutes, and most people go home the same day.

To drain, you clean the valve, connect it to a vacuum bottle or bag, and let the fluid flow out. A nurse teaches you and a family member before you leave, and a home health nurse may visit for the first few drainages. Supplies are shipped to your home.

When a patient needs a needle drainage every week or two, I bring up the catheter early. The goal is simple: fewer hospital visits and more good days at home. I always check the ultrasound to see how the fluid lies and whether the lung or bowel is stuck down, because that helps me choose the safest spot for the tube.

Fabio Komlos, MD, interventional radiologist · About Dr. Fabio Komlos

The most important risk is infection, either at the skin, along the tunnel or in the fluid itself. It is uncommon, and most infections are treated with antibiotics without removing the tube. Other problems include a blocked tube, fluid leaking around the tube, pain during drainage and, rarely, the tube coming out. Some people need the tube removed or replaced.