FX vs. ECG Guidance for PICC Insertion

2018-09-05 23:45:11 | BioPortfolio


The aim of this study is to compare two techniques of placing a peripherally inserted central venous catheter (PICC). The first technique, uses ECG based electromagnetic guidance (ECG-EM). The second (reference technique), is guided by X-ray (fluoroscopy).


The method of placement under fluoroscopic control (FX) is considered as the reference technique. This is often criticized for disadvantages such as costs, logistical problems and relative ionizing radiation. Despite this, it is still advised by 75% of PICC providers.

Appeared about ten years ago, a per procedural guiding technique with intracavitary ECG tracking (ECG-EM) presents a better technical success (precision and specificity) than the blind technique, but there is still a lack in comparing this technique to the FX technique.

This prospective randomized controlled study is designed to compare the PICC insertion using ECG-EM guidance to fluoroscopic (FX) guidance in order to define whether a replacement of the FX technique by ECG-EM is appropriate in terms of the final catheter tip position of the PICC as well as length of the outgoing catheter at the entry point.

All included patients gave their written consent and the study is approved by EC.

Participation is open to all adults referred to the radiology department of the CHUV for insertion of a PICC (monocentric).

Recruited patients will be randomly assigned to one of the two arms (FX or ECG-EM).

For both procedures patient position and preparation (MSB, maximal sterile barrier) are standardized and are similar.

FX method consists on a puncture of an arm vein, under the ultrasound control and local anesthesia. Through the point of puncture, a long wire is then introduced and directed to the level of the target zone located in the superior vena cava under fluoroscopy control. The length of the guide inside the vessel is then measured to adjust the length of the PICC necessary for its optimal positioning.

For ECG-EM insertion technique, the vein puncture is done in similar conditions to the FX method. The length of the PICC is estimated prior to its insertion using morphological landmarks. The placement of the PICC is done using SHERLOCK 3CG™ Diamond Tip Confirmation System (TCS) (CE marked device; C. R. Bard, Inc.).

At the end of procedure, a chest x-ray is performed to assess the PICC position. Possible per-procedural complications are documented.

After intervention, the patient is transferred back to the ward or sent home in stable conditions.

Study Design


Long Term Antibiotics


ECG-EM Guidance, FX Guidance


Not yet recruiting


University of Lausanne

Results (where available)

View Results


Published on BioPortfolio: 2018-09-05T23:45:11-0400

Clinical Trials [3564 Associated Clinical Trials listed on BioPortfolio]

3D CT Guidance for Transjugular Intrahepatic Portosystemic Shunt Creation

To prospectively evaluate the efficacy of real-time 3D CT-image guidance and CO2 portography during transjugular intrahepatic portosystemic shunt (TIPS) creation.

An Intraoperative Guidance Platform for Radio Frequency Ablation

This study tests the hypothesis that use of the research RFA (Radiofrequency ablation) Physics Library will result in more frequent technical success (complete necrotization of target tiss...

Pre-hospital Ultrasound Guided Peripheral Venous Catheter Insertion

This study evaluates two different techniques for ultrasound guided peripheral venous catheter insertion in pre-hospital emergency care in comparison with conventional approach without any...

Injections in the Diagnosis and Treatment of Lumbar Facet Syndrome

In suspected facet joints pain, it is recommended to perform nerve blocks to establish the diagnosis with positive results being and indicator of successful of most permanent treatment of ...

Using 3D Imaging to Optimize Bifurcation Stenting

The primary purpose of this study is to determine whether bifurcation stenting guided by on-line three-dimensional optical frequency domain imaging (3D-OFDI) is superior to that with angio...

PubMed Articles [12957 Associated PubMed Articles listed on BioPortfolio]

Long-term antibiotics for Chronic Rhinosinusitis: changing views.

Based on data from Asia showing the positive effect of long-term antibiotics in diffuse panbronchiolitis, a number of studies have been performed on the effect of long-term macrolides on symptomatolog...

Appropriate selection of echocardiographic guidance for transcatheter atrial septal defect closure.

Transesophageal echocardiography (TEE) under general anesthesia (GA) or intracardiac echocardiography (ICE) under sedation is usually used for echocardiographic guidance during transcatheter atrial se...

Hepatitis C Guidance 2019 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection.

The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) initiated the hepatitis C guidance project (hereafter HCV guidance) in 2013. The ...

The effect of antibiotics on the composition of the intestinal microbiota.

Antibiotics cause changes in the intestinal microbiota. The magnitude of the effect of antibiotics on the microbiota and whether the effects are only short-term or persist long-term remain uncertain. ...

Essential elements of an outpatient total joint replacement programme.

To summarize the safety and feasibility of outpatient total joint arthroplasty (TJA) from the perspectives of short-term complications, long-term functional outcomes, patient satisfaction and financia...

Medical and Biotech [MESH] Definitions

The mechanism by which a neuronal process outgrows toward a target led by the GROWTH CONE. Local guidance cues are provided by cell surface proteins that act on the growing axon.

The tendency of an individual or individuals to rely on others for advice, guidance, or support.

Consisting of video recordings or other files that reveal material selectively according to user guidance.

Facilities which administer the delivery of mental health counseling services to children.

Systematic efforts to assist individuals in selecting an occupation or suitable employment on the basis of aptitude, education, etc.

More From BioPortfolio on "FX vs. ECG Guidance for PICC Insertion"

Quick Search

Relevant Topic

Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...

Searches Linking to this Trial