Risk Factors for Difficulty and Complications Associated with Peripherally Inserted Central Catheter Insertion

外周置入中心静脉导管置入困难及并发症的风险因素

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Abstract

Purpose: This retrospective study investigated the factors influencing the difficulty and complications of peripherally inserted central catheter insertion. Material and Methods: The study evaluated 189 cases of peripherally inserted central catheter insertion (139 patients) performed in our angiography unit from October 2023 to March 2024. Each vein was punctured under ultrasound guidance, and a guidewire and catheter were advanced under fluoroscopic guidance. The patients were classified into two groups based on the procedural time (≤10 minutes [short group] and >10 minutes [long group]), number of punctures, occurrence of procedure-related complications, and performance of venography, and patient characteristics and procedural details were compared in these groups. Results: The long group featured a significantly higher proportion of female patients, deeper vessel depth, smaller vessel diameter, and higher proportion of junior residents among the operators than in the short group. The multiple-puncture group had a significantly younger age, higher proportion of female patients, and deeper vessel depth than the single-puncture group. The complication group had a younger age, lower platelet count, and deeper vessels than the non-complication group. The venography group exhibited a significantly smaller vessel diameter than the non-venography group. Conclusions: For peripherally inserted central catheter insertion, younger age, female sex, deeper and smaller vessels, and less operator experience were associated with procedural difficulty. Younger age, low platelet counts, and deeper vessels were associated with procedural complications. A smaller vessel diameter was associated with the need for venography. These factors should be considered when selecting the operator, insertion site, method, and operation site to ensure a reliable procedure.

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