Antithrombogenic peripherally inserted central catheters: overview of efficacy and safety

Expert Rev Med Devices. 2019 Jan;16(1):25-33. doi: 10.1080/17434440.2019.1555466. Epub 2018 Dec 6.


Introduction: Thrombotic complications associated with peripherally inserted central catheters (PICCs) are common, as most synthetic materials when placed in the presence of serum often result in platelet activation, fibrin deposition, thrombotic occlusion, and potentially embolization. A current innovation focus has been the development of antithrombogenic catheter materials, including hydrophilic and hydrophobic surfaces. These are being incorporated into PICCs in an attempt to prevent the normal thrombotic cascade leading to patient harm.

Areas covered: This review focuses on the laboratory efficacy and clinical effectiveness of antithrombogenic PICCs to prevent PICC-associated thrombosis, as well as their efficiency and safety. This synthesis was informed by a systematic identification of published and unpublished laboratory and clinical studies evaluating these technologies.

Expert commentary: A range of PICCs have been developed with antithrombogenic claims, using varying technologies. However, to date, there is no peer-reviewed laboratory research describing the individual PICCs' effectiveness. Despite promising early clinical trials, adequately powered trials to establish efficacy, effectiveness, efficiency, and safety of all of the individual products have not yet been undertaken.

Keywords: Central venous catheter thrombosis; central venous catheters; deep vein thrombosis; peripheral venous catheterization; upper extremity deep vein thrombosis; venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Catheterization, Central Venous / adverse effects*
  • Catheterization, Central Venous / economics
  • Catheterization, Peripheral*
  • Central Venous Catheters* / economics
  • Cost-Benefit Analysis
  • Humans
  • Product Surveillance, Postmarketing*
  • Thrombosis / economics
  • Thrombosis / therapy*
  • Treatment Outcome