Reducing catheter-associated thrombosis

"This retrospective study demonstrated that small improvements to controllable elements of catheter care in a broad patient population can result in significant reductions in the risk of CAT and associated costs" Zazyczny et al (2026).

"This retrospective study demonstrated that small improvements to controllable elements of catheter care in a broad patient population can result in significant reductions in the risk of CAT and associated costs" Zazyczny et al (2026).

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Reducing catheter-associated thrombosis

Abstract:

Aim:
Catheter-associated thrombosis (CAT) is a potential complication of vascular access devices, including peripherally inserted central catheters (PICCs), which can result in therapy interruption, increased cost of care, and patient consequences including phlebitis and pulmonary embolism. There are multiple modifiable (e.g., catheter size, insertion, and location confirmation methods) and nonmodifiable (e.g., cancer, history of thrombosis) risk factors for CAT. A multidisciplinary approach focused on quality improvement may help to lower risk.

Methods: A retrospective study of patients with PICCs placed by vascular access nurses was conducted after a quality improvement initiative at a hospital within a 1200-bed health system in Philadelphia. A pre-post analysis was performed to compare the rates of CAT before and after a multiyear intervention targeting modifiable risk factors. An economic model calculated economic impact based on results of the observational audit.

Results: Across the health system, very low CAT rates (1.2%) were observed in the post-intervention period, compared with a pre-intervention rate of 4.6%. The greatest reduction was attributed to the elimination of 6-Fr PICCs as part of the intervention. For every 1000 PICC placements, the economic model predicted cost savings exceeding $1M USD (i.e., $1,399,644) due to avoided thrombosis.

Conclusions: This retrospective study demonstrated that small improvements to controllable elements of catheter care in a broad patient population can result in significant reductions in the risk of CAT and associated costs. Further study is required to confirm benefits in larger populations, and to understand which modifications could result in the highest cost savings.

Reference:

Zazyczny, K. A. et al. (2025) ‘Multidisciplinary Approach for Reducing Risk of Catheter-Associated Thrombosis,’ Journal of the Association for Vascular Access, 30(4), pp. 22–29. Available at: https://doi.org/10.2309/JAVA-D-25-00012 (Accessed: 11 July 2026).