Comparison of different techniques for the management of venous steno-occlusive lesions during placement of peripherally inserted central catheter
- Authors
- Yang, Woo Jin; Kang, Danbee; Shin, Ji Hoon; Jang, Eun Ho; Noh, Seung Yeon; Park, Suyoung; Chu, Hee Ho; Kim, Jong Woo
- Issue Date
- 13-May-2021
- Publisher
- Nature Research
- Citation
- Scientific Reports, v.11, no.1
- Journal Title
- Scientific Reports
- Volume
- 11
- Number
- 1
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81219
- DOI
- 10.1038/s41598-021-89780-6
- ISSN
- 2045-2322
- Abstract
- The purpose of this study is to investigate strategies for peripherally inserted central catheter (PICC) placement in patients with venous steno-occlusive lesion (VSOL). We performed a retrospective cohort study in adults with central or peripheral VSOL who underwent PICC placement procedures from January 2015 to December 2018. Four different strategies [selecting alternative pathway/over the wire (SAP/OTW), percutaneous transluminal angioplasty (PTA), re-puncture in ipsilateral arm (RIA), and catheter placement in the contralateral arm (CICA)] were analyzed and we compared the clinical outcomes by strategy and compared the strategy between central and peripheral VSOLs. During 4 years, 258 PICC procedures performed in patients with VSOLs, 100 PICC were included in the analysis. The overall technical success rate of initial attempt with SAP/OTW was 32.2%. As a second-line technique, PTA was most frequently used in both central (100%) and peripheral (68.2%) VSOL groups. The clinical success rates within 2 months of SAP/OTW, PTA, RIA, CICA were 55.2%, 43.2%, 14.3%, and 33.3%, respectively (P = 0.24). In conclusion, when the SAP/OTW failed, the PTA can be preferred as a second-line technique for both central and peripheral VSOLs. When guidewire passage fails, the operator could adopt the RIA or CICA technique as an alternative method. © 2021, The Author(s).
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