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Clinical diagnosis and treatment of peripherally inserted central catheter related upper extremity deep venous thrombosis

Xuming Bai, Xingshi Gu, Long Cheng, Qiang Yuan, Jian Jing, Yinfen Jiang, Yong Jin, Chungen Xing

Objective: This study aimed to investigate clinical diagnosis and treatment of Peripherally Inserted Central Catheter (PICC) related deep vein thrombosis.

Materials and Methods: A retrospective study was performed for 19 cases of patients with concurrent upper extremity deep vein thrombosis after inserting PICC from August 2011 to December 2014 in our hospital.

Results: There were 8 cases and 11 cases with PICC in the right upper extremity and left upper extremity, respectively. All 19 cases had swelling of the upper extremities and discomfort after activity, and 18 cases had varying degrees of pain after activity. By ultrasonography 18 cases were diagnosed with deep vein thrombosis and 1 case with suspected deep vein thrombosis. All 19 patients underwent the indwelling thrombolysis catheter-directed thrombolysis based on anticoagulation therapy, thrombolysis time was 2-6 (3.16 ± 1.10 d), including 16 cases (89%) at grade III thrombolysis and 3 cases (11%) at grade II thrombolysis. 17 patients (89.5%) were clinically recovered and 2 cases (10.5%) were improved, with a total efficiency of 100%. No serious complication was noticed during thrombolysis. After thrombolysis, four cases were diagnosed as phlebostenosis and received stent implantation treatment. During follow-up of 6-36 months, no cases had recurred thrombosis and post-thrombotic syndrome.

Conclusion: PICC related deep vein thrombosis could be diagnosed by color Doppler ultrasonic with venography as a supplement. Catheter-directed thrombolysis technique is characterized by short thrombolysis time, safety and efficiency for the treatment of C related deep vein thrombosis.