Intravascular Complications of Central Venous Catheterization in Chronic Hematological Diseases: Low Risk with Peripherally Inserted Catheters in a Single-Center Retrospective Large Study
Related Experiment Video
Updated: Jan 14, 2026
Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
Published on: March 31, 2023
Claudia Giordano1, Marco Picardi1, Annamaria Vincenzi1
1Department of Clinical Medicine and Surgery, Hematology Unit, Federico II University Medical School, Naples,Italy.
Insights
Long-term peripherally inserted central catheters (PICCs) are safe for patients with chronic hematologic diseases, showing a low symptomatic venous thrombosis (s-VT) risk. The incidence of s-VT was comparable to other central venous access devices.
Area of Science:
- Hematology
- Vascular Access
- Thrombosis Research
Background:
- Evaluating the long-term impact of peripherally inserted central catheters (PICCs) on symptomatic venous thrombosis (s-VT).
- Focusing on patients with chronic hematologic diseases requiring PICC placement for at least 90 days.
- Observational study conducted at a single Italian Hematology Unit from 2014-2023.
Purpose of the Study:
- To assess the incidence and risk profile of symptomatic venous thrombosis (s-VT) associated with long-term PICC use in hematology patients.
- To compare the thrombotic risk of PICCs with other central venous access devices in this specific patient population.
Main Methods:
- Retrospective review of clinical charts for 1150 patients with chronic hematologic diseases and in-situ PICCs (median duration 300 days).
- Analysis of underlying hematologic conditions including non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, and others.
- Calculation of s-VT incidence per 1000 implantation days and time to thrombotic event.
Main Results:
- Symptomatic venous thrombosis (s-VT) occurred in 2.6% of patients (30 cases), with an incidence rate of 0.13 per 1000 implantation days.
- The median time from PICC insertion to s-VT was 30 days; no serious complications were reported.
- Hodgkin lymphoma showed a numerically higher incidence of PICC-related s-VT compared to other hematologic conditions.
Conclusions:
- Peripherally inserted central catheters (PICCs) are a safe and effective primary central vascular access method for patients with chronic hematologic conditions.
- The thrombotic risk associated with long-term PICC use in this cohort is comparable to totally implantable venous access devices (TIVADs).
- PICCs offer a favorable risk-benefit profile for managing long-term venous access needs in hematology patients.
Introduction:
To evaluate the impact of long-term peripherally inserted central catheters (PICC) on symptomatic venous thrombosis (s-VT), we reviewed clinical charts of patients suffering from chronic hematological diseases with in-situ PICC placement for at least 90 days after catheterization at the Hematology Unit of the Federico II University Medical School of Naples (Italy). The period of observation was between January 2014 and December 2023.
Methods:
A total of 1150 PICCs were inserted into 1150 patients at the hematologic diagnosis. Underlying chronic diseases were the following: non-Hodgkin lymphoma (n = 760, 66.1%), Hodgkin lymphoma (n = 200, 17.4%), multiple myeloma (n = 100, 8.7%), chronic lymphocytic leukemia (n = 50, 4.3%), severe aplastic anemia (n = 15, 1.3%), sickle cell disease (n = 10, 0.9%), thalassemia (n = 10, 0.9%), and hemophilia (n = 5, 0.4%). PICCs were successfully inserted in all cases. The median duration of in-situ PICC placement was 300 days (range, 120-400 days).
Results:
A s-VT occurred in 30 cases (2.6%), with a rate of 0.13 (95% CI, 0.04-0.30) per 1000 implantation days. The median period time between PICC insertion and thrombotic episode was 30 days (range, 4-95 days). No serious complication was associated with these events. Hodgkin lymphoma (compared to the other diseases) resulted in a numerically higher incidence of PICC-related s-VT.
Conclusion:
PICCs represent a useful and safe frontline central vascular approach for patients with chronic hematologic diseases, with a thrombotic risk profile comparable to that reported with centrally inserted totally implantable venous access devices (TIVADs).
More Related Videos
09:57A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
07:47The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:24Hemodialysis II: Procedure and Complications
01:25Hemodialysis I: Introduction
01:29Venous Thrombosis III: Interprofessional Care
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:29Endocarditis IV: Nursing Management