Edward Wolfgang Lee MD, PhD, Presenter: Nothing to Disclose

Jonathan D. Grant BS, Abstract Co-Author: Nothing to Disclose

Christopher Loh MD, Abstract Co-Author: Nothing to Disclose

Stephen Thomas Kee MD, Abstract Co-Author: Nothing to Disclose

1.To evaluate an incidence and complications of upper extremity deep vein thrombosis (UEDVT) after placement of percutaneously inserted central catheter (PICC) line. 2.To demonstrate trends of PICC line placement and UEDVT at a single institution over 4 years.

Upon IRB approval, the Radiology database was reviewed to retrieve all patients who had PICC line placement between January 2003 and December 2006. A total of 6,513 PICC lines were placed in 4,223 patients in 4 years. Of 6,200 PICC line placements, 189 patients were diagnosed with UEDVT due to PICC line placement.

Of the 4,223 patients, we retrieved 2,231 male and 1,992 female patients who had PICC line placement with mean age of 56. The basilic veins (66.5%) and brachial veins (15%) were accessed most frequently. In 1,046 patients (24.8%), two or more PICC lines had been placed within a four-year period. An average of 1550 PICC lines were placed each year with a significant increase between 2003 and 2004 from 1058 PICCs to 1883 PICCs due to increased number PICCs placed by trained NPs and RNs. There was a total 1449 UEDVTs (occlusive and non-occlusive thrombosis) in 4 years with an annual average of 362±33. No significant increase in number of UEDVT was observed. The right upper extremities had more DVT (56%) than left. Of the 1449 patients, 42.6% received treatment, 39.0% without any treatment and 13.2% with conservative treatment. A total of 189 patients were diagnosed with UEDVT due to PICC line placement, which translates to a rate of 3.0%. The incidence of UEDVT due to PICCs was 47.3±10.4 per year. This reflects an average of 13.1±2.9 % of total UEDVT per year. Of the 189 patients, 71 patients (37.6%) had complications including pulmonary embolism, recurrent thrombosis, infection and mortality.

1.UEDVT due to PICC line placement is a serious entity with various detrimental complications. 2.Although PICC line placement is relatively safe, high suspicion for UEDVT should be given to patients with predisposing risk factors or symptoms.

Upper extremity deep vein thrombosis due to PICC line placement is a serious entity with various complications including pulmonary embolism and mortality.

Lee, E, Grant, J, Loh, C, Kee, S, Is PICC Line Placement a Huge Risk for Upper Extremity Deep Vein Thrombosis?: Evaluation of 6,200 PICC Lines Placed in 4 Years at a Single Institution.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015270.html