Purpose: Patients needing medium- to long-term infusion therapy with limited catheterization via the superior vena cava system is a challenging condition. The conventional catheterization via the femoral vein in the groin has a high complication rate, discomfort, and short indwelling time. Since changing the insertion site can avoid the disadvantage of conventional catheterization via the femoral vein in the groin, the present study aimed to investigate the effects of femoral inserted central catheters insertion via the superficial femoral vein at the mid-thigh to resolve the issue of limited superior vena cava system catheterization. Methods: Based on the symptoms and signs, enhanced computed tomography findings, and insertion history, in 121 patients, limited catheterization via the superior vena cava system was identified. Subsequently, the femoral inserted central catheters were inserted via the superficial femoral vein at the mid-thigh under the guidance of ultrasound, and the tip of femoral inserted central catheters was in the inferior vena cava. Results: A total of 121 patients underwent femoral inserted central catheters insertion via a superficial femoral vein at the mid-thigh from August 2017 to December 2018. The success rate of insertion was 100%, and the indwelling time was 3–472 days. The complications of femoral inserted central catheters in the thigh were similar to that of peripherally inserted central catheters in the arm. The incidence of primary malposition was 1.65%, the incidence of catheter-related thrombosis was 0.83%, and the central line associated bloodstream infection rate was 0.83%. Subsequently, 116 lines (95.87%) were removed at the end of the treatment, one line (0.83%) was accidentally removed by the patient, and four lines (3.31%) were unplanned removed due to complications. Conclusion: The technique of femoral inserted central catheters insertion via the superficial femoral vein at the mid-thigh has a high success rate, low complication rate, and less impact on activities, and is easy to maintain. This phenomenon resolves the patient’s needs of medium- to long-term infusion therapy with limited catheterization of superior vena cava system.

Purpose: To explore the incidence, signs and symptoms, causes and prognosis of anaphylactoid reactions in PICC catheterization. Methods: Prospectively observe the occurrence of anaphylactoid reactions in coated and uncoated PICC during insertion from November 2018 to April 2020. A diagnosis of anaphylactoid reactions was based on the signs and symptoms and laboratory results, and then collect data for analysis. Results: A total of 1439 coated catheters were inserted, of which 30 resulted in anaphylactoid reactions (2.08%). The signs and symptoms were mainly skin system symptoms, combined with respiratory, cardiovascular, and digestive system symptoms. The anaphylactoid reaction rates of coated catheters were higher than those of uncoated catheters (χ2 = 38.417, 19.352, p < .01). A 29 of 30 patients completed catheterization after symptoms were resolved, these catheters were removed after treatment completion. Catheterization was terminated in one patient. There were no anaphylactoid reactions in 2850 uncoated catheters. Conclusion: Anaphylactoid reactions may occur during catheterization when using the coated PICC, which should be paid attention to in clinical application.