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Comparative Study of Techniques for Restoring Function in Thrombotically Occluded Peripherally Inserted Central
Feng-Xian Li1, Peng Su, Yue-Bing Li
1Author Affiliations: Department of Oncology, Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, People's Republic of China (F.-X. Li, Y.-B. Li, H.-W. Li, and H.-H. Gao); Department of Orthopedics, Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, People's Republic of China (Su).
Insights
The intermittent negative-pressure guidewire technique is more effective at restoring function in blocked peripherally inserted central catheters (PICCs) than the stay-locking technique, showing higher success rates and faster operation times.
Area of Science:
- Vascular Access Devices
- Interventional Radiology
- Catheter Patency Maintenance
Background:
- Thrombotic occlusion frequently impedes the function of peripherally inserted central catheters (PICCs).
- Restoring PICC function is crucial for continued patient therapy and avoiding catheter replacement.
Purpose of the Study:
- To compare the efficacy, safety, and operational efficiency of two techniques for clearing thrombi from occluded PICCs.
- Evaluate the intermittent negative-pressure guidewire technique against the stay-locking technique in an in vitro model.
Main Methods:
- An in vitro model of thrombotically occluded PICCs was established.
- 90 occluded PICCs were randomized into two groups: intermittent negative-pressure guidewire technique (n=43) and stay-locking technique (n=45).
- Procedural data including success rate, thrombus overflow, operation time, and pressure recovery were collected and analyzed.
Main Results:
- The intermittent negative-pressure guidewire technique achieved a significantly higher success rate (62.79%) compared to the stay-locking technique (4.44%).
- Successful interventions with the negative-pressure technique were associated with shorter operation times and higher pressure recovery rates.
- While thrombus overflow incidence was similar, the length of overflow was greater in the control group.
Conclusions:
- The intermittent negative-pressure guidewire technique is superior for restoring function in thrombotically occluded PICCs compared to the stay-locking technique.
- This technique offers improved efficacy, evidenced by higher success rates and reduced operation times.
- The significant pressure recovery indicates effective restoration of catheter function.
Objective:
To compare the efficacy, safety, and operational efficiency of the intermittent negative-pressure guidewire technique and the stay-locking technique in restoring the function of thrombotically occluded peripherally inserted central catheters (PICCs).
Methods:
An in vitro thrombotically occluded PICC model was created using 110 catheters, with successful occlusion established in 90. The experimental group comprised 43 models treated with the intermittent negative-pressure guidewire technique, while the control group included 45 models treated using the stay-locking technique. Relevant procedural data were collected and analyzed statistically.
Results:
The success rate was significantly higher in the experimental group (62.79%) compared with the control group (4.44%, P < .0001). There was no significant difference in the incidence of thrombus overflow at the catheter tip between groups (P = .704); however, the length of thrombus overflow was significantly greater in the control group (P = .001). Additionally, successful interventions were associated with significantly shorter operation times and significantly higher-pressure recovery rates (P < .0001 for both comparisons).
Conclusion:
In an in vitro model of thrombotically occluded PICCs, the intermittent negative-pressure guidewire technique demonstrated superior efficacy, including shorter operation time and higher success rates, compared with the stay-locking technique. The marked increase in the pressure recovery rate in successful cases indicates the technique's effectiveness in restoring catheter function.
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