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Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors

V Chopra1, D Ratz, L Kuhn

  • 1The Patient Safety Enhancement Program, The Center for Clinical Management Research, Ann Arbor, MI, USA; The VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; The University of Michigan Health System, Ann Arbor, MI, USA.

Journal of Thrombosis and Haemostasis : JTH
|March 12, 2014
PubMed

Insights

Peripherally inserted central catheters (PICCs) increase deep vein thrombosis (DVT) risk, especially in cancer patients and with larger gauges. Careful consideration of PICC size and patient history is crucial for prevention.

Area of Science:

  • Vascular access devices
  • Thrombosis research
  • Medical device safety

Background:

  • Peripherally inserted central catheters (PICCs) are widely used but linked to deep vein thrombosis (DVT).
  • Identifying factors contributing to PICC-associated DVT is critical for patient safety.

Purpose of the Study:

  • To investigate patient, provider, and device-related factors associated with peripherally inserted central catheter (PICC)-associated deep vein thrombosis (DVT).

Main Methods:

  • Retrospective cohort study of 966 adult PICC placements (June 2009-June 2012).
  • Symptomatic PICC-associated DVT and lower-extremity DVT were confirmed by ultrasound.
  • Multivariable logistic and Cox-proportional hazards regression analyses were employed.

Main Results:

  • 42 thrombotic events occurred; 33 were PICC-associated DVT and 9 were lower-extremity DVT.
  • Recent cancer diagnosis (OR 1.95) and larger PICC gauge (5-Fr HR 2.21, 6-Fr HR 3.56) were significantly associated with PICC-DVT.
  • Interventional radiology placement, chemotherapy, and number of lumens showed association on bivariate analysis.

Conclusions:

  • Recent cancer diagnosis and larger PICC gauge (5-Fr and 6-Fr) are independent risk factors for PICC-DVT.
  • These findings highlight the need for improved policies regarding PICC selection in cancer patients and the use of larger gauge devices to mitigate thrombosis risk.
Abstract

Keywords:
central venous catheter thrombosiscentral venous cathetersdeep vein thrombosisperipheral venous catheterizationupper extremity deep vein thrombosisvenous thromboembolism

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