Intravascular Complications of Central Venous Catheterization in Chronic Hematological Diseases: Low Risk with Peripherally Inserted Catheters in a Single-Center Retrospective Large Study.

[INTRODUCTION] To evaluate the impact of long-term peripherally inserted central catheters (PICC) on symptomatic venous thrombosis (s-VT), we reviewed clinical charts of patients suffering from chronic hematological diseases with in-situ PICC placement for at least 90 days after catheterization at the Hematology Unit of the Federico II University Medical School of Naples (Italy). The period of observation was between January 2014 and December 2023.

[METHODS] A total of 1150 PICCs were inserted into 1150 patients at the hematologic diagnosis. Underlying chronic diseases were the following: non-Hodgkin lymphoma (n = 760, 66.1%), Hodgkin lymphoma (n = 200, 17.4%), multiple myeloma (n = 100, 8.7%), chronic lymphocytic leukemia (n = 50, 4.3%), severe aplastic anemia (n = 15, 1.3%), sickle cell disease (n = 10, 0.9%), thalassemia (n = 10, 0.9%), and hemophilia (n = 5, 0.4%). PICCs were successfully inserted in all cases. The median duration of in-situ PICC placement was 300 days (range, 120-400 days).

[RESULTS] A s-VT occurred in 30 cases (2.6%), with a rate of 0.13 (95% CI, 0.04-0.30) per 1000 implantation days. The median period time between PICC insertion and thrombotic episode was 30 days (range, 4-95 days). No serious complication was associated with these events. Hodgkin lymphoma (compared to the other diseases) resulted in a numerically higher incidence of PICC-related s-VT.

[CONCLUSION] PICCs represent a useful and safe frontline central vascular approach for patients with chronic hematologic diseases, with a thrombotic risk profile comparable to that reported with centrally inserted totally implantable venous access devices (TIVADs).