title: Peripherally inserted central catheter placement in cancer patients with profound thrombocytopaenia: a prospective analysis.
abstract: OBJECTIVE
  No studies have specifically evaluated the safety of peripherally inserted central catheter (PICC) placement in patients with profound thrombocytopaenia. We prospectively determined the frequency of haemorrhagic complications of PICC placement in cancer patients with uncorrected profound thrombocytopaenia.
  
  
  METHODS
  Profound thrombocytopaenia was defined as a platelet count <50 × 10(9)/l. No patients received transfusions before or after the procedure. Three types of adverse effects were analysed: minor oozing, mild haematoma and major haemorrhage.
  
  
  RESULTS
  One hundred and forty-three PICC implantations in 101 cancer patients were prospectively included in the study: seven patients (7 %) had a solid tumour and 94 (93 %) a haematological malignancy. Among these 143 procedures in thrombocytopaenic patients, 93 (65 %) were performed with a platelet count 20-50 × 10(9)/l and 50 (35 %) had lower than 20 × 10(9)/l. No major haemorrhage was observed. Minor oozing was observed in six implantations (4 %) and mild haematoma in two (1.5 %), for a total of eight minor haemorrhagic adverse events (5.5 %). In patients with a platelet count <20 × 10(9)/l, 1/50 (2 %) had minor oozing and none had minor haematoma.
  
  
  CONCLUSIONS
  In cancer patients with uncorrected profound thrombocytopaenia, the incidence of adverse events after PICC implantation was low, and was limited to minor haemorrhagic adverse events.
  
  
  CONCLUSIONS
  • PICC placement has high technical success in profound thrombocytopaenic cancer patients. • Few adverse events are encountered after PICC placement, limited to minor haemorrhage. • PICC placement does not routinely require platelet transfusion in patients with thrombocytopaenia. • Such PICC placement still seems safe when the platelet count is <20 × 10 (9) /l.
authors: Radiology Department, Percy Military Hospital, Avenue Henri Barbusse, 92140 Clamart, France. potet_julien@yahoo.fr
authors: Julien
authors: J
authors: Potet
authors: Alphonse
authors: A
authors: Thome
authors: Emmanuel
authors: E
authors: Curis
authors: François-Xavier
authors: FX
authors: Arnaud
authors: Gabrielle
authors: G
authors: Weber-Donat
authors: Laura
authors: L
authors: Valbousquet
authors: Evelyne
authors: E
authors: Peroux
authors: Eric
authors: E
authors: Flor
authors: Christophe
authors: C
authors: Dody
authors: Johanna
authors: J
authors: Konopacki
authors: Jean Valère
authors: JV
authors: Malfuson
authors: Cecile
authors: C
authors: Cartry
authors: Marion
authors: M
authors: Lahutte
authors: Thierry
authors: T
authors: de Revel
authors: Jacques
authors: J
authors: Baccialone
authors: Christophe A
authors: CA
authors: Teriitehau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D062905:Central Venous Catheters / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D061214:Patient Safety; D010976:Platelet Count; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult