Symptomatic Deep Vein Thrombosis Associated With Peripherally Inserted Central Catheters of Different Diameters: A Systematic Review and Meta-Analysis

• Published in: Clinical and Applied Thrombosis/Hemostasis 2023-01, Vol.29, p.10760296221144041-10760296221144041
• Main Authors: Bahl, Amit, Alsbrooks, Kimberly, Gala, Smeet, Hoerauf, Klaus
• Format: Article
• Language: English
• Subjects: Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Catheters; Catheters - adverse effects; Central Venous Catheters - adverse effects; Clinical outcomes; Economic models; Health risks; Humans; Retrospective Studies; Review; Risk Factors; Thrombosis; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/10760296221144041

We assessed the relationship between peripherally inserted central catheter (PICC) diameters and symptomatic deep vein thrombosis (DVT) rates. We conducted a systematic search for articles published between 2010 and 2021 reporting DVT incidence by catheter diameter in patients who had a PICC, followed by meta-analyses for DVT risk in each diameter group. Pooled DVT rates were incorporated into an economic model. Of 1627 abstracts screened, 47 studies were included. The primary meta-analysis of 40 studies demonstrated the incidence of DVT was 0.89%, 3.26%, 5.46%, and 10.66% for 3, 4, 5, and 6 French (Fr) PICCs (P  =  .01 between 4 and 5 Fr). Rates of DVT were not significantly different between oncology and nononcology patients (P  =  .065 for 4 Fr and P  =  .99 for 5 Fr). The DVT rate was 5.08% for ICU patients and 4.58% for non-ICU patients (P  =  .65). The economic model demonstrated an annual, incremental cost savings of US$114 053 for every 5% absolute reduction in 6 Fr PICCs use. Using the smallest PICC that meets the patients’ clinical needs may help to mitigate risks and confer savings.