Venous Thromboembolism Risk Associated with MIDLINE Catheters and Peripherally Inserted Central Catheters, a...

Area of Science:

• Vascular Access Devices
• Thrombotic Risk Assessment
• Medical Device Safety

Background:

• Peripherally inserted central catheters (PICCs) and midline catheters (MCs) are common for vascular access.
• The venous thromboembolism (VTE) risk associated with PICCs is known, but MCs' thrombotic safety profile is unclear.
• Conflicting evidence and varied definitions complicate VTE risk assessment for MCs.

Purpose of the Study:

• To systematically review and meta-analyze the incidence of VTE between PICCs and MCs.
• To compare the thrombotic safety profiles of MCs and PICCs.
• To explore heterogeneity in VTE rates based on insertion technique, placement setting, and publication period.

Main Methods:

• Systematic review and meta-analysis of studies comparing VTE incidence.
• Primary outcome: VTE incidence by catheter type (PICC vs. MC).
• Subgroup and sensitivity analyses were conducted to address heterogeneity.

Main Results:

• 19 studies included 29,680 catheters (14,200 MCs, 15,480 PICCs).
• No significant difference in overall VTE rates between MCs (3.5%) and PICCs (3.8%) (OR=0.92).
• Catheter-related thrombosis (CRT) rates also did not differ significantly (OR=1.14).

Conclusions:

• Midline catheters (MCs) exhibit a thrombotic profile comparable to peripherally inserted central catheters (PICCs).
• VTE risk alone is insufficient to guide the selection between MCs and PICCs.
• Further prospective research with standardized definitions is needed for optimal vascular access device selection.