Avoiding PICC-line extractions: Improvement project on PICC-associated DVTs in oncology

Abstract

Background: Peripherally inserted central catheter (PICC) lines are used to deliver chemotherapy directly into large veins to prevent phlebitis and extravasation. In the cancer service of Queen Elizabeth Hospital Birmingham we insert around 900 PICC lines a year. The most frequent complication of PICC line is upper arm deep vein thrombosis (DVT), which develops around the line in 4.1% of patients (as per data from our initial audit). Before 2020 the standard practice of managing these DVTs included anticoagulation followed by line extraction and subsequent reinsertion.