Peripherally inserted central catheters: guidance with use of US versus venography in 2,650 patients

J Vasc Interv Radiol. 1999 Apr;10(4):473-5. doi: 10.1016/s1051-0443(99)70067-9.

Abstract

Purpose: To compare technical success and initial complication rates of peripherally inserted central catheters (PICCs) by interventional radiologists using ultrasound (US) or venographic guidance.

Materials and methods: With use of a computer database, the authors retrospectively reviewed 2,650 procedures, 2,126 of which were performed with US and 524 with venography. Technical success was defined as placement of a PICC. Initial complications were defined as development of a hematoma, inadvertent arterial puncture, or neuropathy. Statistical significance was assessed using the chi2 test.

Results: During 33 consecutive months, 2,650 procedures were performed with a complication rate of 1.0%. The technical success rate was 95.8% for venography and 99.6% for US. The initial complication rate was 0.75% for venography and 1.08% for US. There was no statistically significant difference in immediate complication rates (P = .50); however, there is statistical significance in regard to technical success (P < .001).

Conclusion: There is no difference in initial complication rates when comparing US and venographic guidance for PICC insertion. The decision to use either method can be based on clinical grounds and/or physician preference, although US has a higher initial success rate.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arm / blood supply
  • Arteries / injuries
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheterization, Central Venous / methods
  • Catheterization, Central Venous / statistics & numerical data
  • Chi-Square Distribution
  • Databases as Topic
  • Female
  • Hematoma / epidemiology
  • Humans
  • Illinois / epidemiology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Peripheral Nervous System Diseases / epidemiology
  • Phlebography* / statistics & numerical data
  • Radiography, Interventional* / statistics & numerical data
  • Retrospective Studies
  • Ultrasonography, Interventional* / statistics & numerical data
  • Veins