Deep Vein Thrombosis: The Incidence Post-PICC Line Placement

Abstract

Background: Peripherally Inserted Central Catheters (PICC) are being increasingly used in the hospital setting. However, there are a number of complications associated with PICCs, particularly upper extremity deep and/or superficial venous thrombosis, leading to Post-Thrombotic Syndrome (PTS), pulmonary embolism, and increased risk of Catheter-Related Infections (CRI). Objective: To review the occurrence of deep and superficial vein thrombosis in patients who have undergone PICC placement and also to highlight the complications, epidemiology, risk factors, diagnosis, and management of PICCrelated thrombosis in patients. Data sources and extraction: We performed article searches and obtained electronic literature from the following databases: PubMed, EMBASE, and Google scholar using key terms. We utilized St. Mary Mercy Hospital for patient data abstraction. Summary of review: There is evidence that has shown peripherally inserted central catheters may double the risk of deep and superficial venous thrombosis compared with Centrally Inserted Venous Catheters (CIVCs). Duplex ultrasound is the preferred diagnostic imaging modality to rule-out thrombosis. Conclusion: Medical records on 1,429 PICC-line insertion patients were reviewed. A venous duplex examination was performed on all of the patients who were noted to have complications post-procedure. The duplex was also performed on patients who manifested symptoms such as pain, swelling, and/or extremity discoloration after catheter insertion. The data abstracted concluded, 59% of symptomatic patients post-peripherally inserted central catheters tested positive for Deep Vein Thrombosis (DVT). Once there was sufficient evidence to prove deep vein thrombosis, the catheter was removed or the patient was started on anticoagulation.