Greater Risk of Thromboembolism with PICCs than Other Central Venous Catheters

When compared with other central venous catheters, peripherally inserted central catheters (PICCs) are associated with an increased risk of venous thromboembolism, according to the results of a study published in the July 27, 2013, issue of theLancet. The study’s researchers performed a systematic review and meta-analysis of 64 studies that included 29,503 patients and found that the weighted frequency of PICC-related deep-vein thrombosis was highest in patients who were cared for in intensive care unit settings and among those who were diagnosed with cancer. To explain the increased risk of thromboembolism, the researchers mention that PICCs have longer dwell times than central venous catheters and are inserted into peripheral veins that are more likely to occlude in the presence of a catheter that occupies much of the luminal diameter. In addition, the fact that PICCs placed in the internal jugular, rather than arm veins, are associated with a lower incidence of deep-vein thrombosis supports the theory that intimal injury from repeated arm movements could contribute to PICC-related deep-vein thrombosis.