Efficacy and Safety of Midline Catheters with Integrated Wire Accelerated Seldinger Technique

Vasc Specialist Int. 2022 Mar 21:38:2. doi: 10.5758/vsi.210062.


Purpose: The midline catheter (MC) is a peripheral venous access device with the catheter tip located in the axilla and available for mid-term intravenous (IV) therapy. This study evaluated the efficacy and clinical outcomes associated with the placement of MCs with an integrated wire-accelerated Seldinger technique for IV access.

Materials and methods: A retrospective review was conducted at a single center in South Korea between March 2020 and July 2020. Consecutive patients in whom MC insertions were performed by vascular surgeons were enrolled. The outcomes included catheter indwelling time and incidence of catheter-related adverse events.

Results: Ninety-five patients (117 catheters) were included in the study. The total indwelling time was 1,964 days, with a median of 16.7 days (range, 0-76). The complication-free catheter rates at 5 and 28 days were 92.9% and 65.5%, respectively. Overall, 32 (27.4%) catheters were removed due to complications; however, major complications, such as symptomatic deep venous thrombosis and catheter-induced bloodstream infections, were confirmed in only 3 (2.6%) catheters. A common reason for premature catheter removal is inadvertent removal owing to patient inattention. A high body mass index and female sex were identified as risk factors for short indwelling times and complicated premature catheter removal.

Conclusion: MC insertion is a simple and operator-friendly procedure with a low rate of major complication. It enables mid-term IV treatment through a single procedure if there are no specific complications, thereby improving quality of life of patients during hospital stay.

Keywords: Indwelling catheters; Intravenous infusions; Peripheral venous catheterization; Vascular access devices.