[When peripheral drips fail: favourable experience with peripherally-inserted central venous catheters]

Evaluation of the technical success rate, insertion complications and patient survival when peripherally-inserted central venous catheters (PICCs) are used in oncologic patients and patients with severe infections in whom it was not possible to place a peripheral drip.

Retrospective cohort study.

Patient records and the radiological computer system RADOS were searched and analysed for data regarding patients, variables at the time of PICC insertion, indwelling time and the reasons for PICC removal.

During the period 1 September 2000 - 30 June 2007, 68 patients underwent 101 attempts for PICC placement. Ninety-one (91%) procedures were successful in 64 patients. There were 2 (2%) periprocedural complications; local haematoma (n=1) and palpitations (n=1). At the time of data analysis 14 (15%) PICCs were still in situ. Forty-five (50%) had been removed electively after a mean period of 114 (range: 10-446) days. Thirty-two (35%) PICCs had been removed prematurely after a mean period of 67 (range: 7-266) days. Reasons for premature removal were infection (n=14, 15%), migration (n=10, 11%), dislocation (n=4, 4%), clinical thromboses (n=2, 2%) and occlusion (n=2, 2%).

PICCs appear to be a good alternative in oncologic patients and patients with infections in whom peripheral drip insertion is not possible. The technical success rate of PICCs was high and was associated with a low periprocedural complication rate. The percentage of prematurely removed catheters seems acceptable, in part because these catheters were removed after a mean period of 2 months.