Intravascular catheters-an ultrasound imaging based observational study of position and function

Area of Science:

• Medical Devices
• Vascular Access
• Diagnostic Imaging

Background:

• Peripheral catheters (intravenous and intra-arterial) frequently occlude with limb movement.
• The cause of blockage is often misattributed to intraluminal structures, lacking strong evidence.

Purpose of the Study:

• To investigate the causes of catheter blockage during limb movement using ultrasound.
• To quantify catheter tip movement and its correlation with blockage.
• To compare blockage rates between different catheter insertion sites.

Main Methods:

• Ultrasound assessment of 62 venous and 21 radial arterial catheters.
• Evaluation of catheter tip movement and vessel wall impingement.
• Correlation of blockage with catheter kinking, vessel spasm, and limb flexion.

Main Results:

• Catheter blockage primarily caused by vessel wall impingement, kinking, and spasm.
• Mean tip movement: 12.3 mm (hand venous), 5.7 mm (forearm venous), 9.5 mm (radial arterial).
• Forearm venous catheters had significantly lower blockage (20%) than dorsal hand (83%). Radial artery catheters showed 52% blockage with wrist flexion.

Conclusions:

• Vessel wall impingement is the main cause of peripheral catheter blockage.
• Forearm venous catheter placement offers advantages over dorsal hand placement due to reduced blockage.
• Optimizing catheter placement can improve patency and reduce complications.