SHM Converge Scientific Abstract ePoster Gallery-Midline Catheter Associated Thrombosis: Does the Catheter Tip Location Matter?

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This retrospective cohort study examined whether midline catheter tip location affects the risk of midline catheter-associated thrombosis (MCAT). The authors reviewed inpatients who received radiology-placed midline catheters in 2021 and had both a chest x-ray within 30 days and an upper-extremity duplex within 90 days. Tip location was classified as either in an arm vein or in the axillary vein. The final cohort included 59 patients: 41 with arm vein tips and 18 with axillary vein tips.<br /><br />Patient characteristics were generally similar between groups. Thrombosis occurred at comparable rates: clot was identified in 41.5% of arm-vein cases and 38.9% of axillary-vein cases. In the primary analysis, axillary tip location was not associated with increased MCAT risk compared with arm-vein tip location (adjusted OR 0.62, 95% CI 0.18–2.12). A sensitivity analysis restricted to ipsilateral clots also found no significant increase in risk (OR 1.27, 95% CI 0.39–4.12).<br /><br />The authors concluded that axillary vein tip placement does not appear to increase thrombosis risk relative to arm-vein placement. They noted that most axillary-tip catheters were standard 20 cm catheters, suggesting that avoiding axillary placement by trimming may not be necessary and could add complexity and error risk. However, the study was limited by small sample size and relatively short dwell times, so larger studies are needed to assess longer-term outcomes, including possible central venous stenosis.<br /><br />Overall, the findings suggest current guidelines may need to reconsider the recommendation to avoid axillary vein tip placement in midline catheters.

Asset Subtitle

Max S. Schechter

Meta Tag

Author List Arash Gohari, Benjamin T. Galen, Max S. Schechter, Sarah W. Baron, William N. Southern

Category Research

Concept Midline Catheter

Concept Catheter Tip Location

Concept Midline Catheter-Associated Thrombosis

Concept Axillary Vein

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization Albert Einstein College of Medicine

Presenting Author Max S. Schechter

Track Patient Safety

Keywords

midline catheter

catheter tip location

axillary vein

arm vein

thrombosis

midline catheter-associated thrombosis

retrospective cohort study

duplex ultrasound

catheter placement

vascular access

Midline Catheter

Catheter Tip Location

Midline Catheter-Associated Thrombosis

Axillary Vein

Retrospective Cohort Study