Comments about the Medcomp Pro-PICC CT | Which Medical Device
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PICC Lines
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Comments
Comment by rodo Commented Jun 13, 2011
Impact factor: 140
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We have implanted one hundred 5F single lumen pro-PICC CT catheters over approximately one year with a single operator. The technique used was a US guided vein puncture with blind positioning after anthropometric measurement conducted in an angio suite.
10 PICCs were implanted totally blind at the bedside without complications with a plain X-ray at the end, to confirm the tip position. CVC were equally divided in RT and LT arm, but my own preference is for left one (I am right handed ).
No serious complications were observed in this series of patients. About one third of the procedure required me to use fluoroscopy to follow the guidewire through the vein. Only in 4 cases was it necessary to use as alternative wire (Boston Scientific .018 extra stiff platinum tip 58cm guidewire) instead of the original nitinol wire provided by Medcomp.
A variety of different US machines were used for vein puncture but my favourite still remains the Bard Site-Rite IV with mechanical 7.5 or 9MHz transducers which have a very small footprint.
The cephalic vein was preferred over the basilic vein. On 10 occasions the brachial vein was requested to be used.
Mean vein puncture attempts was 1.8 per case.
At the end of the procedure a couple of fluro frames were taken to confirm the distal tip of the CVC. No misplacements into the IJV or azygos were observed. The mean procedural time was 18 minutes.
I have no concerns about the kit by Medcomp but the 21G security needle is often too long to be comfortable with small syringes.
Pro-PICC CT were also used to inject contrast medium during CT scans, also with Iomeron 400 (Bracco, Italy) that is quite viscous, up to the promised 5 ml/sec without problems.