Catheter-related thrombosis in cancer patients with tunnelled non-cuffed centrally inserted central catheters: a...

Peripherally inserted central catheters (PICCs) are widely used in oncology but are associated with higher rates of catheter-related thrombosis compared to other central venous access devices. Tunnelled non-cuffed centrally inserted central catheters (tnc-CICC) may offer a safer alternative in patient at high risk of thrombosis.

This retrospective cohort study evaluated 193 tnc-CICCs placed in 182 cancer patients at a tertiary oncology unit between January 2021 and December 2022. Primary outcomes is catheter-related thrombosis; secondary outcomes are procedural duration and complication rates. Data were analysed using non-parametric statistical methods.

The overall thrombosis rate was 1% (0.18 per 1,000 catheter days), significantly lower than reported PICC-associated thrombosis rates. No major intraoperative complications occurred. The overall complication rate was 19.7%, with catheter malfunction (9.3%), migration (5.2%) and bloodstream infections (4.1%) being the most common. Median procedural time was 34 min, with no significant difference based on operator experience.

Off label use of PICCs as tnc-CICCs seems safe and effective. It provides an alternative to PICCs in oncology patients at high risk of thrombosis, even when placed by operators with low experience levels. These findings support the inclusion of tnc-CICCs in vascular access algorithms for cancer patient at high risk of thrombosis and suggest feasibility for nurse-led insertion programs.