J Surg Ultrasound.  2019 May;6(1):8-13. 10.0000/jsu.2019.6.1.8.

What Is a Practical Catheter Vein Ratio to Lower the Incidence of PICC-Related Symptomatic Thrombosis?

• Kong T
• Ohe H
• Kim K
• Choi KW
• Kim YK
• Lee WY
• Chang YG
• Hong SW

• KMID: 2465875
• DOI: http://doi.org/10.0000/jsu.2019.6.1.8

Abstract

PURPOSE
The catheter vein ratio (CVR) is one of control factors related to the incidence of catheter related thrombosis (CRT). This paper reports a practical CVR to reduce the incidence of CRT in patients receiving PICC.
METHODS
Information on patients with PICC insertion between January 2018 and December 2018 was extracted retrospectively from a single center. The information was composed of age, sex, BMI, access locations, comorbidities, catheter sizes, catheter days, catheter removal cause, and CRT. The incidence of CRT and other factors were analyzed.
RESULTS
Of the 164 patients who underwent PICC and 2,697 catheter days in the study, three patients (1.8%) experienced a symptomatic thrombosis. Without significance to other factors, the incidence of thrombosis was relevant only in those with higher CVR vs. those with lower CVR (P = 0.047). In addition, its cut-off value was 36.5% (AUC 0.813, 95% CI: 1.003-1.495). Compared to the higher and lower than 36.5% CVR, the odd ratio was 38.25 in the group with a higher than 36.5% CVR (95% CI: 3.129-467.611, P = 0.010).
CONCLUSION
CVR is one of the factors that can be controlled to reduce the clinical relevance of CRT. A lower than 36.5% CVR should be maintained to be in the safety zone from PICC related thrombosis.

Keyword

PICC; CVR; Thrombosis; Ultrasound; Diameter

MeSH Terms

Catheters*
Comorbidity
Humans
Incidence*
Retrospective Studies
Thrombosis*
Ultrasonography
Veins*

Figure

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  Fig. 1 Measurement of inner diameter of vein by ultrasonogram.

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  Fig. 2 Definition of catheter to vein ratio.

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  Fig. 3 Receiver operating characteristic analysis identifying the optimal catheter to vein ratio to reduce the risk of venous thrombosis.

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  Fig. 4 Compressibility of the catheterized vessel, a simple and reliable method for determining catheter-related thrombosis.

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