title: Comparison of complication rates of Hickman(®) catheters versus peripherally inserted central catheters in patients with acute myeloid leukemia undergoing induction chemotherapy.
abstract: Central venous access devices (CVADs) are used for intravenous therapy in patients with hematological malignancies. There are limited data comparing catheter outcomes in patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. A retrospective review comparing the incidence of early and late CVAD-associated complications and their effect on CVAD removal was performed in patients with AML undergoing induction chemotherapy between 2007 and 2011. Overall, 64 Hickman(®) catheters and 84 peripherally inserted central catheters (PICCs) were inserted. There was a trend toward increasing use of PICCs. The rate of CVAD occlusion was higher in PICCs compared to Hickman catheters (48.2% vs. 3.2%), for a rate of 20.43 vs. 1.25 per 1000 CVAD-days (p = 0.0001). There was no significant difference in the rates of CVAD-associated thrombosis, premature removal, blood stream infection (BSI) and CVAD-related BSI. Importantly, there was no significant difference in the rate of CVAD removal between Hickman catheters and PICCs for the duration that the CVADs were in place. The choice of type of CVAD inserted into patients with newly diagnosed AML will depend on ease of catheter placement, cost, perception of frequency and severity of complications, and clinician preference.
authors.affiliation: Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
authors.forename: Ming Y
authors.initials: MY
authors.lastname: Lim
authors.forename: Aref
authors.initials: A
authors.lastname: Al-Kali
authors.forename: Aneel A
authors.initials: AA
authors.lastname: Ashrani
authors.forename: Kebede H
authors.initials: KH
authors.lastname: Begna
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Elliott
authors.forename: William J
authors.initials: WJ
authors.lastname: Hogan
authors.forename: C Christopher
authors.initials: CC
authors.lastname: Hook
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kaufmann
authors.forename: Louis
authors.initials: L
authors.lastname: Letendre
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.forename: Mrinal S
authors.initials: MS
authors.lastname: Patnaik
authors.forename: Animesh
authors.initials: A
authors.lastname: Pardanani
authors.forename: Ayalew
authors.initials: A
authors.lastname: Tefferi
authors.forename: Alexandra P
authors.initials: AP
authors.lastname: Wolanskyj
authors.forename: Diane E
authors.initials: DE
authors.lastname: Grill
authors.forename: Rajiv K
authors.initials: RK
authors.lastname: Pruthi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D055815:Young Adult