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Peripherally inserted central catheter thrombosis--reverse tapered versus nontapered catheters: a randomized
Maxim Itkin1, Jeffrey I Mondshein1, S William Stavropoulos1
1Department of Radiology, Section of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
Journal of Vascular and Interventional Radiology : JVIR
|November 26, 2013
Summary
This study found a high rate of thrombosis with peripherally inserted central catheters (PICCs), with no significant difference between nontapered and reverse tapered PICC devices. Further research is needed to address this complication.
Area of Science:
- Vascular Access Devices
- Thrombosis Research
- Medical Device Comparison
Background:
- Peripherally inserted central catheters (PICCs) are widely used for venous access.
- Thrombosis is a known complication associated with PICC insertion.
- Understanding device-specific risks is crucial for patient safety.
Purpose of the Study:
- To compare the thrombosis rates, ease of insertion, bleeding, and complications between nontapered and reverse tapered PICCs.
- To evaluate the clinical performance of two different PICC tip designs.
Main Methods:
- A prospective randomized controlled trial involving 332 patients requiring PICC insertion.
- Patients were randomized to either a nontapered PICC or a reverse tapered PICC group.
- Ultrasound assessment for thrombosis was performed at removal or 28 days post-insertion.
Main Results:
- The overall thrombosis rate was high at 71.9%, with no statistically significant difference between the nontapered (70.4%) and reverse tapered (73.4%) PICC groups (P = .58).
- Symptomatic thrombosis rates were 4.3% and 3.6% respectively (P = .75).
- Patients with cancer exhibited a significantly higher thrombosis rate (71.9% vs 66.7%, P = .002).
Conclusions:
- A high incidence of thrombosis occurs with PICC insertion, posing significant morbidity risks.
- This study did not detect a difference in thrombosis rates between nontapered and reverse tapered PICC devices.
- Further investigation into mitigating PICC-related thrombosis is warranted.
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