Symptomatic Deep Vein Thrombosis Associated With Peripherally Inserted Central Catheters of Different Diameters: A Systematic Review and Meta-Analysis

Clin Appl Thromb Hemost. 2023 Jan-Dec:29:10760296221144041. doi: 10.1177/10760296221144041.


We assessed the relationship between peripherally inserted central catheter (PICC) diameters and symptomatic deep vein thrombosis (DVT) rates. We conducted a systematic search for articles published between 2010 and 2021 reporting DVT incidence by catheter diameter in patients who had a PICC, followed by meta-analyses for DVT risk in each diameter group. Pooled DVT rates were incorporated into an economic model. Of 1627 abstracts screened, 47 studies were included. The primary meta-analysis of 40 studies demonstrated the incidence of DVT was 0.89%, 3.26%, 5.46%, and 10.66% for 3, 4, 5, and 6 French (Fr) PICCs (P = .01 between 4 and 5 Fr). Rates of DVT were not significantly different between oncology and nononcology patients (P = .065 for 4 Fr and P = .99 for 5 Fr). The DVT rate was 5.08% for ICU patients and 4.58% for non-ICU patients (P = .65). The economic model demonstrated an annual, incremental cost savings of US$114 053 for every 5% absolute reduction in 6 Fr PICCs use. Using the smallest PICC that meets the patients' clinical needs may help to mitigate risks and confer savings.

Keywords: French size; catheter diameter; catheter-related thrombosis; meta-analysis; peripherally inserted central catheters; systematic review; upper extremity deep vein thrombosis; venous thromboembolism.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Catheterization, Central Venous* / adverse effects
  • Catheterization, Peripheral* / adverse effects
  • Catheters / adverse effects
  • Central Venous Catheters* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Venous Thrombosis* / epidemiology
  • Venous Thrombosis* / etiology