Ultraschall- und durchleuchtungsgesteuerte Implantation peripher inserierter zentral-venöser Katheter (PICC)

Zusammenfassung

Ziel: Evaluation der ultraschall- und durchleuchtungsgesteuerten Platzierung peripher inserierter zentral-venöser Katheter (PICC). Material und Methode: 32 Patienten (12 Männer, 20 Frauen; mittleres Alter 64,1 ± 11,9 Jahre) mit klinischer Indikation zur Implantation eines langfristigen zentral-venösen Zugangs (Chemotherapie: n = 5; parenterale Ernährung und Flüssigkeitssubstitution: n = 26; Schmerztherapie: n = 1) wurde nach ultraschallgesteuerter Punktion einer Vene des Oberarms ein zentral-venöser Katheter (PICC) platziert. Ergebnisse: 31 (96,9 %) PICC konnten erfolgreich inseriert werden. Implantiert wurden 20 Single-Lumen 5-F-Katheter, 4 Zwei-Lumen 6-F-Katheter und 7 Zwei-Lumen 7-F-Katheter. Die durchschnittliche Verweildauer der Katheter betrug 28,4 (2 - 161) Tage bei insgesamt 910 Kathetertagen. Es traten keine Katheterokklusionen auf. Bei zwei ­Patienten entwickelten sich Thrombosen der Venen der oberen Extremität. Dies entsprach einer Rate von 2,2 pro 1 000 Katheterliegetagen. Eine katheterassoziierte Infektion wurde nicht beobachtet. Schlussfolgerung: Die Implantation eines zentral-venösen Katheters nach ultraschallgesteuerter Punktion einer peripheren Vene des Oberarms ist eine Alternative zur Implantation zentral-venöser Katheter nach Punktion zentraler Venen und sollte breitere Anwendung im klinischen Alltag finden.

Abstract

Purpose: Evaluation of ultrasound- and fluoroscopy-guided implantation of peripherally inserted central venous catheters (PICCs). Materials and Methods: In 32 patients (12 males, 20 females; mean age 64.1 ± 11.9 years) with clinical indication for long term central venous catheter (chemotherapy: N = 5; parenteral nutrition and fluid substitution: N = 26; parenteral pain therapy: N = 1) a PICC was placed by an interventional radiologist using ultrasound guidance. Results: The placement of the PICC was technically successful in 31 (96.9 %) patients, with placement of 20 single-lumen 5F PICCs, 4 double-lumen 6F PICCs and 7 double-lumen 7F PICCs. The mean duration of catheter usage was 28.4 (2 - 161) days with a total of 910 catheter days. No catheter occlusions were recorded. Two patients developed a superficial venous thrombosis of the upper extremity. The resulting thrombotic rate was 2.2 per 1000 catheter days. No catheter associated infection was recorded. Conclusion: The ultrasound guided placement of peripherally inserted central venous catheters (PICCs) via a superficial vein of the upper extremity is a practical alternative to central catheters via central veins.

Central venous catheter - ultrasound - complications

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