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Peripherally inserted central venous catheter lines (PICC-line) are successfully used since many years in patients who need long-term frequent IV therapy. The PICC placement is performed under fluoroscopy The study objective is to compare the effectiveness and safety of the Seldinger wire technique (over-the-wire) using a 145 cm guidewire with the modified Seldinger technique using a 70 cm guidewire.
The referral of patients with indication to PICC-line implantation at the institute of diagnostic and interventional radiology occurs through different departments of the University Hospital Jena. The patients are registered for radiological treatment and checked again by a radiologist if a PICC-line implantation is indicated. If this is the case, the radiologist conducts an informed consent discussion with the patient about possible complications and risks during intervention and informs him also about a possible study participation. After signature of the written informed consent, the patient is included. He can, at any time, withdraw his consent. On the intervention day, the patient is randomly assigned to one of the two study arms through envelope (145 cm vs 70 cm). The intervention time is documented. After intervention, the patient is transferred back to the ward or sent home. The examination of the puncture site before discharge is performed by a ward physician or by the family doctor.
Within 2 weeks after PICC-line implantation, the treating physician is contacted and questioned about possible complications (catheter occlusion, haematoma, infection of the puncture site, arm vein thrombosis, pain, etc.), that are then thoroughly documented.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| over-the-wire technique with 145 cm guidewire | Active Comparator | Catheter tip placement using Seldinger over-the-wire technique with 145 cm guidewire |
|
| modified technique with 70 cm guidewire | Active Comparator | Catheter tip placement using Seldinger modified technique with 70 cm guidewire |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Angiodynamic Bioflo Picc IR-KIT (145 cm guidewire) or | Device | Before Power-PICC-line catheter implantation, the patients undergo an examination of the planned intervention site and ultrasound check, and analysis of the blood tests. An informed consent discussion and the patient's signature on the informed consent are obligatory. The length of the catheter and the optimal position of the catheter tip are verified by fluoroscopy. After catheter implantation, the tip location is verified by a final chest x-ray. The follow-up visit and the control of the puncture site until removal of the catheter are performed during hospitalization or subsequently by the treating family doctor. |
| Measure | Description | Time Frame |
|---|---|---|
| Implantation time | Economy of time until beginning of treatment | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Placement accuracy of catheter tip compared to chest x-ray | by final chest X-ray | 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Heike Habrecht, Dr. | Institute of Diagnostic and Interventional Radiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Jena | Jena | Thuringia | 07740 | Germany |
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Depending on randomization, the Power-PICC implantation occurs either with Seldinger over-the-wire technique or with Seldinger modified technique. All related substances, measures or procedures are performed according to the clinical routine.
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On the intervention day, the patient is randomly assigned to one of the two study arms through envelope (145 cm vs 70 cm)
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| Angiodynamic Bioflo Picc MST-KIT (70 cm guidewire) | Device | Before Power-PICC-line catheter implantation, the patients undergo an examination of the planned intervention site and ultrasound check, and analysis of the blood tests. An informed consent discussion and the patient's signature on the informed consent are obligatory. The length of the catheter and the optimal position of the catheter tip are verified by fluoroscopy. After catheter implantation, the tip location is verified by a final chest x-ray. The follow-up visit and the control of the puncture site until removal of the catheter are performed during hospitalization or subsequently by the treating family doctor. |
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