# Central line and port removal: when, how and what to watch for afterwards

Source: https://onco.cc/protocols/central-line-removal/  
OnCo record `central-line-removal` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A central line or port is taken out when treatment is finished or if it causes a problem such as an infection or clot. The usual precautions, lying flat as it comes out, a sealed dressing afterwards and being watched for a while, aim to prevent a rare but serious problem: air getting into the vein.

## Summary

Lines come out when no longer essential (CDC Category IA) or for complications. ESMO (2015) lists the infective indications: severe sepsis, septic thrombophlebitis, endocarditis, tunnel infection, port abscess, bloodstream infection persisting beyond 48 to 72 hours of adequate treatment, or infection with Staphylococcus aureus, fungi or mycobacteria [II, A]. For catheter-related thrombosis, where the line is no longer needed or anticoagulation cannot continue long term, ESMO recommends 3 to 5 days of anticoagulation before removal to avoid clot embolisation [I, A]; the separate catheter-related thrombosis protocol sets out where ITAC and ASCO differ. Catheter tips are cultured only when the line is removed for suspected infection, not routinely (IDSA A-II); for a port, the reservoir contents are cultured too.

The removal technique itself (lying flat or head down, breath-holding or Valsalva as the catheter leaves, firm pressure and an occlusive dressing over the tract, and a period of observation) comes from nursing standards that could not be read. The reason is air embolism: a 2026 systematic review of 28 case reports of delayed air embolism after removal found symptoms began 10 minutes to over 2 hours afterwards, a persisting skin-to-vein channel in over 90% of those imaged, permanent neurological harm in 18% and death in 32%. ESMO's management of air embolism is to lay the patient head down on their side and give 100% oxygen.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: PICC removal; port removal; Hickman line removal; CVAD removal; taking out a central line; line removal air embolism; port explant

## Connected records

- protocols: [Catheter-related thrombosis in people with cancer: diagnosis, anticoagulation and whether the line can stay](https://onco.cc/protocols/catheter-related-thrombosis-in-cancer/), [Central venous catheter insertion for anticancer treatment: PICC, tunnelled line and implanted port](https://onco.cc/protocols/central-venous-catheter-insertion-for-anticancer-therapy/), [Suspected central line infection in a person with cancer: paired blood cultures, first antibiotics and line removal or salvage](https://onco.cc/protocols/suspected-central-line-infection/)
- technologies: [Implanted ports for chemotherapy (port-a-cath, power-injectable, apheresis and intraperitoneal ports)](https://onco.cc/technologies/implanted-ports/), [Peripherally inserted central catheters (PICC lines)](https://onco.cc/technologies/picc-lines/)
- terms: [Central venous access (port, PICC line)](https://onco.cc/terms/central-venous-access/)

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