title: Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve.
abstract: Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions' durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Rotzinger
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Gero
authors.initials: G
authors.lastname: Wieners
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Freyhardt
authors.affiliation: 1 Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: 2 Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Maurer
mesh_terms: D002405:Catheterization, Central Venous / Q000191:economics* / Q000295:instrumentation / Q000379:methods*; D062905:Central Venous Catheters / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000191:economics; D011871:Radiology / Q000193:education*; D011872:Radiology Department, Hospital / Q000191:economics*; D012189:Retrospective Studies; D013997:Time Factors
keywords: Vascular access devices; central venous catheterization; costs and cost analysis; endovascular procedures; learning curve; peripheral catheterization