Journal of Vascular Medicine & Surgery

Abstract

The Incidence of Peripherally Inserted Central Catheter Symptomatic Pulmonary Embolism after Line Removal: A Retrospective Analysis

Suman M Wasan, Omar L Esponda, Natalie Feland, Julia L Mathew and Winter J Smith

Background: To date, there are no recommendations regarding the timing of removal of peripherally inserted central catheters (PICC) in the presence of confirmed upper extremity deep vein thrombosis (UEDVT).
Objective: We aimed to determine the incidence of symptomatic pulmonary embolism (PE) post line removal in patients with PICC-associated UEDVT according to treatment strategy.
Patients/Methods: We conducted a retrospective study in adult patients who received a PICC with documented UEDVT or superficial thrombosis (UESVT) by vascular ultrasound. Patients’ demographic characteristics, co-morbid diseases, medications, ultrasound findings, treatment strategy for UEDVT/SVT and occurrence of symptomatic PE after PICC removal was documented.
Results: 124 patients had PICC-associated UEDVT or UESVT; 69 males and 55 females with mean age 52.2 years. Of 81 patients meeting study criteria, 57 patients had UEDVT and 24 patients UESVT. No episodes of symptomatic PE after PICC removal were documented. Regarding timing of removal, 20 patients had their PICC removed within 24 hours after UEDVT diagnosis, 15 within 1 week, 7 within 2 weeks, 11 within 1 month and 4 at more than a month after diagnosis of UEDVT. No patients had objectively confirmed PE during the follow up period.
Conclusion: This retrospective analysis revealed no symptomatic PE with removal of PICC in the presence of UEDVT or UESVT if performed within 24 hours, and an overall low rate of PE events regardless of treatment strategy and duration of PICC insertion. These findings are hypothesis generating and should be confirmed in a prospective trial.