Safety and efficacy of percutaneous trans-lumbar inferior vena cava catheters: A systematic review and meta-analysis.

PURPOSE: This review aims to examine the reported complications associated with IVC catheterization and investigate the reasons for discrepancies between reports.

MATERIALS AND METHODS: The Cochrane Library trials register, PubMed, EMBASE, and Scopus databases were systematically searched for studies that included any terms for IVC and phrases related to catheters or central access. Of 5075 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 by 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% confidence interval (CI).

RESULTS: Compared with catheters < 10 Fr (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 Fr (IR 0.28; %95 CI 0.25, 0.31). Also, dual-lumen catheters showed 0.13 more malfunction per 100 catheter-days (IR 0.27; %95 CI 0.16, 0.37) than single-lumen catheters (IR 0.14; %95 CI 0.09, 0.19). Both differences were statistically significant. Other complications were malposition 0.04 (95% CI; 0.04, 0.05), fracture 0.01 (95% CI; 0.00, 0.02), kink 0.01 (95% CI; 0.00, 0.01), replaced catheter 0.2 (95% CI; 0.1, 0.31), removal 0.13 (95% CI; 0.1, 0.16), IVC thrombosis 0.01 (95% CI; 0.00, 0.03), and retroperitoneal hematoma 0.01 (95% CI; 0.00, 0.01), all per 100 catheter-days.

CONCLUSION: Translumbar 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.