Application of Interventional Venous Access in the Difficult Cases of Peripherally Inserted Central Venous Catheters

Objective To retrospectively analyze the safety and success rate of intervention venous access in patients with difficult insertion of peripherally inserted central venous catheters(PICC).Materials and Methods From January 2008 to November 2010,fifty two patients were inserted PICC line using the antegrade venography and punctured target vein under the fluoroscopy.All of them were evaluated as difficult insertion of PICC line under direct vision by the clinical PICC nurse specialists 's consultation or failed of insertion at the blind bedside insertions.Microguide wire were used in patients with venous tortuosity or mutant.Results 50 in 52 patients were successfully placed PICC lines with a 96.1% success rate.The average period of PICC were 73 days in 50 patients.Among them,46 patients were successfully inserted at the first procedure and 4 was succeed at the second trial.Improved seldinger's puncture sets were used in all procedures while 21 were combined with antegrade venography.Four patients used the microguide wire during the procedure.Complications in this study included 2 cases of deep vein thrombosis(4.0%),1 case of fatal pulmonary embolism(2.0%) and 1 case of aseptic phlebitis(2.0%).Conclusion Application of interventional venous access is safty and can obviously improve the success rate of PICC line insertion,it can also decrease the blindness of bedside catheterization.