Maximal flow rates possible during power injection through currently available PICCs: an in vitro study

Area of Science:

• Medical Imaging
• Interventional Radiology
• Biomaterials Science

Background:

• Peripherally inserted central catheters (PICCs) are commonly used in clinical practice.
• Power injectors are increasingly utilized for contrast-enhanced diagnostic studies.
• The compatibility of PICCs with power injector flow rates requires thorough investigation.

Purpose of the Study:

• To evaluate the suitability of 4-F and 5-F PICCs for contrast medium injection via power injectors.
• To determine the feasibility of using PICCs for contrast-enhanced diagnostic imaging.
• To assess the pressure tolerance of different PICC materials and configurations.

Main Methods:

• An in vitro study evaluated 24 catheter versions (4-F single-lumen, 5-F dual-lumen) from 13 manufacturers.
• Catheters included both silicone and polyurethane materials, tested at full length and trimmed to 40 cm.
• Infusion with contrast medium was performed using CT and power injectors, with increasing flow rates from 0.5 to 17 mL/sec.

Main Results:

• Silicone catheters ruptured at low flow rates (0.5–3.5 mL/sec).
• Polyurethane catheters demonstrated a wide range of rupture pressures, with many tolerating high flow rates (4–15.4 mL/sec, up to 17 mL/sec).
• Rupture locations varied, commonly occurring on the extension legs or proximal catheter.

Conclusions:

• Silicone PICCs are generally unsuitable for the high flow rates required in CT arteriography.
• Many polyurethane PICCs can withstand typical CT arteriography flow rates, suggesting potential for safe use with appropriate protocols.
• Further research and standardized protocols are recommended for the safe application of polyurethane PICCs in power-injected contrast studies.