Efficacy and complications in peripherally inserted central catheter insertion: a study using 4-Fr non-valved catheters and a single infusate.

The purpose of this prospective study was to evaluate the efficacy and complications associated with the use of 4-Fr single-lumen non-valved peripherally inserted central venous catheters (PICC) for the infusion of long-term antibiotics. Forty-four non-valved PICC were inserted using micropuncture technique by interventional radiologists. Six patients were lost to unrelated death or follow up. The remaining 38 patients (24 men and 14 women; mean age 54.79 years) were analysed. Catheters were placed under ultrasound guidance using micropuncture technique and subsequently advanced over guidewire through peel-away sheath under fluoroscopic guidance. Doppler ultrasound was used before PICC removal in order to detect possible complications. All non-valved PICC were flushed with 5 ml of heparinized saline before and after each antibiotic infusion. Efficacy was evaluated and analysed on the average duration of catheter patency and whether any complication was present. Procedural success rate was 100% in our patient population. Seven patients had complications necessitating early PICC removal with the average patency duration of 44 days (95% confidence interval 7.79-80.21 days), whereas an average indwelling patency duration of the remaining 31 patients with no complication was 30.58 days (95% confidence interval 25.74-35.43 days). Total complication rate was calculated to be 5.58 incidences per 1000 catheter days. Complication rate associated with the placement and use of 4-Fr non-valved PICC for antibiotic therapy was observed to be low when compared with other studies using valved and non-valved PICC for various infusates.

Percutaneous retrieval of a chronic foreign body with both intravascular and extravascular components.

Removal of unwanted intravascular foreign body is a useful but infrequent procedure carried out by interventional radiologists. We study a patient who had a long guidewire left in her body following central venous catheter placement by a surgeon. The guidewire was later found in situ, with both intravascular and extravascular components in continuity. We successfully removed the guidewire without causing any complications. Standard interventional techniques, Amplatz gooseneck snare (Microvena, White Bear Lake, MN, USA) and 6-Fr Multipurpose catheter were used.