Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters

Cheng K. Ong, Sudhakar K Venkatesh, Gabriel B. Lau, Shih C. Wang

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1191-1196
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume21
Issue number8
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

Polyurethanes
Silicones
Catheters
Phlebitis
Incidence
Catheter-Related Infections
Phlebotomy
Research Ethics Committees

Keywords

  • catheter-related bloodstream infection
  • CRBSI
  • distal valve silicone PICCs
  • DVSP
  • peripherally inserted central catheter
  • PICCs

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{94d556bbd10d4b66876cc0a31848712a,
title = "Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters",
abstract = "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.",
keywords = "catheter-related bloodstream infection, CRBSI, distal valve silicone PICCs, DVSP, peripherally inserted central catheter, PICCs",
author = "Ong, {Cheng K.} and Venkatesh, {Sudhakar K} and Lau, {Gabriel B.} and Wang, {Shih C.}",
year = "2010",
doi = "10.1016/j.jvir.2010.04.020",
language = "English (US)",
volume = "21",
pages = "1191--1196",
journal = "Journal of Vascular and Interventional Radiology",
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TY - JOUR

T1 - Prospective randomized comparative evaluation of proximal valve polyurethane and distal valve silicone peripherally inserted central catheters

AU - Ong, Cheng K.

AU - Venkatesh, Sudhakar K

AU - Lau, Gabriel B.

AU - Wang, Shih C.

PY - 2010

Y1 - 2010

N2 - 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.

AB - 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.

KW - catheter-related bloodstream infection

KW - CRBSI

KW - distal valve silicone PICCs

KW - DVSP

KW - peripherally inserted central catheter

KW - PICCs

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U2 - 10.1016/j.jvir.2010.04.020

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