Lower limb vascular access
Abstract:
Objective: To compare the clinical application effects of peripherally inserted central catheter (PICC) and deep venous catheters placed through the lower limbs in adults with malignancy obviating the use of upper limb PICC.
Study design: Descriptive study.
Place and duration of study: Department of Oncology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China between February 2017 and February 2019.
Methodology: The patients enrolled in this study were assigned to PICC under ultrasound guidance group and deep venous catheterisation group. The inclusion criteria were patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome; bedridden patients; and patients without mental disorders; who could understand the content of this study and agreed to participate in this study. Patients with high-risk thrombosis and venous thrombosis of lower limbs were excluded. The success rate of one-time catheterisation, the length of catheterisation puncture time, the number of catheterisations, and the occurrence of catheter-related complications of the two groups were compared.
Results: Ultrasound-guided PICC through the lower limbs had a higher success rate than deep venous catheterization (84.6% vs. 42.9%, p=0.046). The average length of puncture time in adults with PICC through the lower limbs under ultrasound guidance was shorter than that in the femoral vein group (24.69 ± 4.35 vs. 29.14 ± 6.02, p=0.038). No catheter-related infection was found in the two groups of patients.
Conclusion: The indications for PICC through the lower limbs in adults include patients with advanced malignant tumor after bilateral breast cancer lymphadenectomy or superior vena cava obstruction syndrome, and mainly bedridden patients. This technique has certain advantages over deep venous catheterisation and is an effective choice for venous access.
Reference:
Li FX, Hao YF, Tian MJ, Li YP, Zhang HY. A Comparison of Lower Limb Peripherally Inserted Central Catheter and Deep Venous Catheterisation. J Coll Physicians Surg Pak. 2021 Dec;31(12):1478-1481. doi: 10.29271/jcpsp.2021.12.1478. PMID: 34794291.