Peripherally inserted central catheters: Guidance with use of US versus venography in 2,650 patients

PURPOSE: To compare technical success and initial complication rates of peripherally inserted central catheters (PICCs) by interventional radiologists using ultrasound (US) or venographic guidance, MATERIALS AND METHODS: With use of a computer database, the authors retrospectively reviewed 2,650 procedures, 2,126 of which were performed with US and 524 with venography, Technical success was defined as placement of a PICC, Initial complications were defined as development of a hematoma, inadvertent arterial puncture, or neuropathy, Statistical significance was assessed using the chi(2) test, RESULTS: During 33 consecutive months, 2,650 procedures were performed with a complication rate of 1.0%. The technical success rate was 95.8% for venography and 99.6% for US. The initial complication rate was 0.75% for venography and 1.08% for US. There was no statistically significant difference in immediate complication rates (P = .50); however, there is statistical significance in regard to technical success (P < .001), CONCLUSION: There is no difference in initial complication rates when comparing US and venographic guidance for PICC insertion, The decision to use either method can be based on clinical grounds and/or physician preference, although US has a higher initial success rate.