Testing for PICC DVT should only be performed in the setting of patient symptoms; screening for DVT in asympotmatic patients is not recommended as the utility is not clear.
Element
Key Institutional Partners
  • Use compression ultrasonography to examine arm veins for thrombosis
Providers
  • Avoid routine “4-limb” screens in patients with fever
Providers
  • Consider CT Angiography for chest/central thrombosis
    • CT Venography is the gold standard for diagnosing catheter-related deep vein thrombosis
Providers
​Resources/Tools
Decision Tools
Articles/References
​Chopra, V et al. Risk of Venous Thromboembolism Associated with Peripherally Inserted Central Catheters: A Systematic Review and Meta-Analysis. LANCET 2013
  • PICCs are associated with a higher risk of deep vein thrombosis than CVCs, especially in patients who are critically ill or those with a malignancy. The decision to insert PICCs should be guided by weighing the risk of thrombosis against the benefit provided by these devices.  
Evans, RS et al. Risk of Symptomatic DVT Associated with Peripherally Inserted Central Catheters. CHEST 2010
  • This article examines risk factors for PICC-associated DVT. They concluded that prior DVT and surgery lasting >1 hour put  patients at increased risk for PICC-associated DVT. Increasing catheter size is also associated with increased risk.  

Evans, RS et al. Reduction of Peripherally Inserted Central Catheter-Associated DVT. CHEST 2013
  • Reduction in PICC-associated DVT can be impacted by increased insertion education and training, persistent DVT surveillance and reporting, and judicious PICC diameter selection.  

Kearon, C et al. Antithrombotic Therapy for VTE Disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012
  • This article provides a detailed summary of the evidence-based medicine recommendations for avoiding and treating thrombosis. 
Validation Survey
DVT Step 6 Validation - Final Validation.
  • This document includes all of the validation questions associated with this content area to help with collaboration on responses for your hospital. Responses to the validation questions should be entered in to the linked document and recorded to monitor progress.