Clinical impact of the Sherlock 3CG® Tip Confirmation System for peripherally inserted central catheters

OBJECTIVE: This study was performed to evaluate the technical success rate and catheter tip malposition rate of peripherally inserted central catheter (PICC) placement using the Sherlock 3CG® Tip Confirmation System (TCS). METHODS: In total, 114 patients who underwent PICC insertion via the Sherlock 3CG® TCS from October 2017 to February 2018 were retrospectively evaluated. The primary endpoints were the technical success rate, malposition rate, and mean procedure time. The secondary endpoints were the sex-related difference in the malposition rate, radiologist’s experience level, and side of insertion. Technical success was defined as procedure completion using only the Sherlock 3CG® TCS without a guidewire or fluoroscopy guidance. In accordance with the North American guidelines, an adequate position was defined as the lower third of the superior vena cava and the cavoatrial junction. RESULTS: The technical success rate was 97% (111/114). The malposition rate was 16% (18/111), and four catheters were repositioned. There were no significant differences in the malposition rate between the sexes, radiologist’s level of experience, or side of insertion. CONCLUSIONS: PICC placement using the Sherlock 3CG® TCS yielded a high technical success rate and low catheter tip malposition rate regardless of the radiologist’s level of experience or side of insertion.