Safety and complications associated with tunneling and pseudotunneling techniques during PICC and Midline insertion.

IF 1.7 3区医学 Q3 PERIPHERAL VASCULAR DISEASE

Journal of Vascular Access Pub Date : 2025-09-01 Epub Date: 2024-10-24 DOI:10.1177/11297298241292218

Stefano Elli, Silvia Cavalli, Valentina Fantini, Marco Fragapane, Nicola Salvoldi, Paolo Zappa, Daniela Zedde, Sabrina Impaziente, Dario D'Amata

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引用次数: 0

Abstract

Introduction: Peripherally Inserted Central Catheters and Midline Catheters are particularly attractive because of their favorable risk/benefit ratio. If the ideal venipuncture site is in an area inappropriate for catheter emergence, a valid alternative is the tunneling technique, which allows the exit site to be moved to reach the optimal position. There are two main types of tunneling techniques: standard tunnel, using a tunneling device (metal tunneler or peel-away tunneler), and pseudo-tunnel. As much as both are recognized as appropriate and safe, there are still few literature data indicating the criteria for choosing and using the two techniques and the possible related complications.

Methods: This retrospective observational investigation analyzed data regarding intra- and post-procedural complications of tunneled catheters inserted using two different techniques. The sample was stratified into three subgroups: (1) Standard Tunnel (patients with no PLT or INR disorders), (2) Pseudotunnel (patients with no PLT or INR disorders), and (3) Pseudotunnel (patients with any PLT or INR disorder). Data regarding the procedure, at 24 h and 7 days were collected and analyzed.

Results: A total of 143 patients who underwent tunneled catheter insertion were included in the study. Among these, 113 patients were divided into subgroups 1 and 2 and 30 were assigned to subgroup 3. No significant differences were found among the three subgroups regarding immediate, short, and medium-term tunnel complications.

Conclusions: The findings of this study suggest that both standard and pseudo-tunnels provide comparable levels of safety and comfort for patients. It was noted that Pseudotunnel offers an equivalent level of safety for patients with coagulation disorders related to PLT and INR, rendering it comparable to a "minimally invasive procedure," which necessitates the same precautions as a non-tunneled PICC.

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PICC 和中线插入过程中隧道和假隧道技术的安全性及相关并发症。

导言：外周置入中心导管和中线导管因其良好的风险/收益比而特别具有吸引力。如果理想的静脉穿刺部位位于不适合导管插入的区域，那么隧道技术就是一种有效的替代方法，它可以移动出口部位以达到最佳位置。隧道技术主要有两种：使用隧道装置（金属隧道器或剥离式隧道器）的标准隧道和假隧道。尽管这两种技术都被认为是合适和安全的，但目前仍很少有文献资料说明选择和使用这两种技术的标准以及可能出现的相关并发症：这项回顾性观察调查分析了使用两种不同技术插入隧道导管的术中和术后并发症数据。样本被分为三个亚组：(1) 标准隧道（无 PLT 或 INR 紊乱的患者），(2) 假隧道（无 PLT 或 INR 紊乱的患者），(3) 假隧道（有任何 PLT 或 INR 紊乱的患者）。收集并分析了手术过程、24 小时和 7 天的相关数据：共有 143 名患者接受了隧道导管插入术。结果：共有 143 名患者接受了隧道式导管插入术，其中 113 名患者被分为亚组 1 和亚组 2，30 名患者被分为亚组 3，三组患者在隧道式导管插入术的即刻、短期和中期并发症方面无明显差异：本研究结果表明，标准隧道和假隧道为患者提供的安全性和舒适度相当。研究指出，假隧道为患有与 PLT 和 INR 相关的凝血功能障碍的患者提供了同等程度的安全性，使其与 "微创手术 "相媲美，因此有必要采取与无隧道 PICC 相同的预防措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Access 医学-外周血管病

CiteScore

3.40

自引率

31.60%

发文量

181

审稿时长

6-12 weeks

期刊介绍： The Journal of Vascular Access (JVA) is issued six times per year; it considers the publication of original manuscripts dealing with clinical and laboratory investigations in the fast growing field of vascular access. In addition reviews, case reports and clinical trials are welcome, as well as papers dedicated to more practical aspects covering new devices and techniques. All contributions, coming from all over the world, undergo the peer-review process. The Journal of Vascular Access is divided into independent sections, each led by Editors of the highest scientific level: • Dialysis • Oncology • Interventional radiology • Nutrition • Nursing • Intensive care Correspondence related to published papers is also welcome.