Safety and Efficacy of Percutaneous Translumbar Inferior Vena Cava Catheters: A Systematic Review and Meta-Analysis |
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| Affiliation: | 1. Department of General Surgery, State University of New York Downstate Health Sciences University, Brooklyn, New York;2. Department of Vascular Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;3. Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York;4. Department of Surgery, State University of New York Downstate Health Sciences University, Brooklyn, New York;5. Division of Vascular Surgery, Tufts University School of Medicine, Boston, Massachusetts;1. Liver Unit and HPB Oncology Area, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain;2. Hepatology Program, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona, Spain;1. Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People’s Republic of China;2. Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China;1. Department of Vascular and Interventional Radiology, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina |
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| Abstract: | PurposeTo examine the reported adverse events associated with inferior vena cava (IVC) catheterization and investigate the reasons for discrepancies between reports.Materials and MethodsCochrane Library trials register, PubMed, Embase, and Scopus databases were systematically searched for studies that included any terms of IVC and phrases related to catheters or central access. Of the 5,075 searched studies, 137 were included in the full-text evaluation. Of these, 37 studies were included in the systematic review, and the adverse events reported in 16 of these 37 identified studies were analyzed. An inverse-variance random-effects model was used to conduct the meta-analysis. Outcomes were summarized by the incidence rate (IR) and 95% CI.ResultsCompared with that of catheters <10 F in size (IR, 0.08; 95% CI, 0.03–0.12), the incidence of catheter-related infections per 100 catheter days was 0.2 more for catheters ≥10 F in size (IR, 0.28; 95% CI, 0.25–0.31). In addition, dual-lumen catheters showed 0.13 more malfunction per 100 catheter days (IR, 0.27; 95% CI, 0.16–0.37) than that shown by single-lumen catheters (IR, 0.14; 95% CI, 0.09–0.19). Both differences were statistically significant. Other adverse events were malposition (IR, 0.04; 95% CI, 0.04–0.05), fracture (IR, 0.01; 95% CI, 0.00–0.02), kinking (IR, 0.01; 95% CI, 0.00–0.01), replaced catheter (IR, 0.2; 95% CI, 0.1–0.31), removal (IR, 0.13; 95% CI, 0.1–0.16), IVC thrombosis (IR, 0.01; 95% CI, 0.00–0.03), and retroperitoneal hematoma (IR, 0.01; 95% CI, 0.00–0.01), all per 100 catheter days.ConclusionsTranslumbar IVC access is an option for patients with exhausted central veins. Small-caliber catheters cause fewer catheter-related infections, and single-lumen catheters function longer. |
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