Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
BLOOD CLOTS WITH PERIPHERALLY INSERTED CENTRAL CATHETERS (PICC) LINES
The study uncovered several risk factors associated with the clots. One was the use of amphotericin B. This is not particularly surprising since this drug is known to be an irritant of the veins. Patients discharged to skilled-nursing facilities were also more likely to develop clots. The authors felt that this was not necessarily due to the quality of care at the facilities. They speculated that these patients were more likely to need help with their daily activities and therefore less likely to move their arms. This lessened activity may have led to clots. Younger patients had higher rates of clotting than the control patients. The authors speculate that this may be due to the higher percentage of HIV-infected patients in the group who had clots. HIV infection is known to be associated with several risk factors for increased clotting.
The authors note that some previous studies have linked the number of attempts it took to get the PICC line inserted with the incidents of clots. Since this study looked at medical records, this data was not available. However, the study did find that most of the clots occurred in the first two weeks after the PICC line was inserted. This may mean that there was an association with insertion technique.
It was also noted that some studies found higher rates of clotting. This may be because other studies were looking closely for clots whether the patients noticed them or not. The study in this report covered only clots reported by patients. Technically, this may be underreporting, but I think that this study is realistic because it reported real patients with real complaints.
People who develop these clots will usually have warfarin prescribed for them.
Reference: Chemaly RF et al. Venous thrombosis associated with peripherally inserted central catheters: A retrospective analysis of the Cleveland Clinic Experience. CID 2002;34:1179-1183.
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Last reviewed May 6 2006