Document Detail


Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters.
MedLine Citation:
PMID:  20598573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The objective of this study was to evaluate and compare the relative durability and complications between the proximal valve polyurethane and distal valve silicone peripherally inserted central catheters (PICCs). METHODS: Institutional review board approval was obtained. A total of 326 patients (mean age, 50.4 years) was assigned randomly to receive either a proximal valve polyurethane PICC (n = 198) or a distal valve silicone Groshong PICC (n = 194). All PICCs were inserted under radiologic guidance by interventional radiologists. Follow-up data were collected until catheter removal because of complications or treatment completion. RESULTS: The mean catheter dwell time was 25.6 days (range, 1-245 days). Complications were encountered in 26.8% and 47.9% of the proximal valve polyurethane PICCs and distal valve silicone PICCs, respectively (P < .001). Significantly higher incidences of phlebitis (23.2% versus 11.6%, P = .003) and catheter-related infection (6.2% versus 2%, P = 0.043) were noted in the distal valve silicone PICCs. No significant differences in the incidence of catheter occlusion, fracture, or dislodgement were found. Multivariate logistic regression analysis showed a higher complication rate in the distal valve silicone PICCs corrected for patients' age, sex, underlying morbidity, indication, peripheral vein accessed, arm used, catheter tip placement, and the number of venepunctures attempted. CONCLUSIONS: Proximal valve polyurethane PICCs were more durable than distal valve silicone PICCs, which were associated with a higher incidence of phlebitis and infection, probably related to the materials of the catheters and the designs and placements of the catheter valves.
Authors:
Cheng K Ong; Sudhakar K Venkatesh; Gabriel B Lau; Shih C Wang
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-07-03
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  21     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1191-6     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Diagnostic Imaging, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore. ongck22@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Catheter-Related Infections / etiology
Catheterization, Central Venous / adverse effects,  instrumentation*
Catheterization, Peripheral / adverse effects,  instrumentation*
Catheters, Indwelling* / adverse effects
Chi-Square Distribution
Device Removal
Equipment Design
Equipment Failure
Female
Humans
Logistic Models
Male
Middle Aged
Phlebitis / etiology
Polyurethanes*
Prospective Studies
Radiography, Interventional
Risk Assessment
Risk Factors
Silicones*
Time Factors
Treatment Outcome
Upper Extremity / blood supply*
Young Adult
Chemical
Reg. No./Substance:
0/Polyurethanes; 0/Silicones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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