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Increased risk of symptomatic upper-extremity venous thrombosis with multiple peripherally inserted central catheter

Ralph Gnannt1,2, Nicolas Waespe3, Michael Temple4

  • 1Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. ralph.gnannt@kispi.uzh.ch.

Pediatric Radiology
|March 1, 2018
PubMed

Insights

Repeatedly inserting peripherally inserted central catheters (PICCs) in the same arm increases the risk of thrombosis. Double-lumen PICCs also pose a higher thrombosis risk than single-lumen lines in children.

Area of Science:

  • Pediatric vascular access
  • Thrombosis research
  • Medical device safety

Background:

  • Peripherally inserted central catheters (PICCs) are linked to upper limb superficial and deep venous thrombosis.
  • Understanding PICC-related thrombosis is crucial for patient safety, especially in pediatric populations.

Purpose of the Study:

  • To investigate the frequency and risk factors of upper limb thrombosis following repeated peripherally inserted central catheter insertions in children.
  • To analyze the sequelae of multiple PICC placements in the same arm.

Main Methods:

  • Retrospective analysis of pediatric patients undergoing first arm PICC insertion between 2010-2015.
  • Inclusion of subsequent ipsilateral arm PICCs and follow-up until March 2016.
  • Correlation of symptomatic deep and superficial thromboses with PICC number and lumen type.

Main Results:

  • Analysis included 2,180 PICCs; 57 upper body deep symptomatic thrombotic events were identified.
  • An increasing odds ratio for thrombosis was observed with higher numbers of PICC insertions in the same arm (significant for 3rd/4th vs. 1st).
  • Double-lumen PICCs showed a significantly higher risk of thrombosis compared to single-lumen lines (OR 2.77).

Conclusions:

  • Repetitive PICC insertions in the same arm are associated with an elevated risk of symptomatic thrombosis in children.
  • The use of double-lumen PICCs increases the likelihood of thrombosis compared to single-lumen lines.
Abstract

Keywords:
CatheterChildrenPeripherally inserted central catheterThrombosisUpper extremityVenous access

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