Risk Factors for Difficulty and Complications Associated with Peripherally Inserted Central Catheter Insertion

Area of Science:

• Vascular Access Procedures
• Interventional Radiology
• Patient Safety

Background:

• Peripherally inserted central catheters (PICCs) are crucial for long-term intravenous access.
• Insertion difficulty and complications can prolong procedures and affect patient outcomes.
• Identifying predictive factors for PICC insertion is essential for improving procedural success and safety.

Purpose of the Study:

• To retrospectively analyze factors influencing the difficulty and complications associated with peripherally inserted central catheter (PICC) insertion.
• To compare patient characteristics and procedural details between groups with varying procedural times, puncture counts, complication occurrences, and venography use.

Main Methods:

• Retrospective evaluation of 189 PICC insertions (139 patients) performed under ultrasound and fluoroscopic guidance.
• Classification of procedures based on duration (≤10 min vs. >10 min), number of punctures, complications, and venography use.
• Comparison of patient demographics, vessel characteristics, and operator experience between these groups.

Main Results:

• Procedural difficulty (longer duration) was associated with younger patients, female sex, deeper/smaller vessels, and less experienced operators.
• Complications were linked to younger age, lower platelet counts, and deeper vessels.
• Smaller vessel diameter correlated with the need for venography.

Conclusions:

• Younger age, female sex, vessel characteristics (depth, diameter), and operator experience are key factors in PICC insertion difficulty.
• Patient factors (age, platelet count) and vessel depth influence complication rates.
• Vessel diameter is a predictor for requiring venography during PICC insertion.