RE: reverse tapering

[Kokotis, Kathy]

Here is your answer:   Let's talk anatomy because you are incorrect   I need you to think how far down is the basilic vessel in the upper arm versus the subclavian vessel in the chest lies in depth in a patient?   Which is going to show symptoms of thrombosis as it is a superficial vessel (Basilic / Cephalic ) of the upper arm.  Which is going to have thrombosis but be silent more often (subclavian).    The TL PICC and DL PICC are a necessity and all of my analysis across the country shows me that the rate of thrombosis reported (that is not silent) is less than 6% which is within the Society of Interventional Radiology Quality Indicator Benchmark.  All of life has some trade-off's.  My mom has had three PICC lines in four years.  I prefer she get a DL or TL PICC vs. a subclavian or jugular.   To get flow, blood draws, reduce occlusions, power injection we need PICC lines of this size.  We have been placing 7F/8F arm ports for years.  Move forward or choose to stay behind.  Your analysis is incorrect.  The majority of PICC lines sold in the US are DL and TL at this point not SL.    I am sorry if I am strong in my message   Kathy        Confidentiality Notice:  This e-mail and any attachments are intended only for the use of those to whom it is addressed and may contain information that is confidential and prohibited from further disclosure under law. If you have received this e-mail in error, its review, use, retention and/or distribution is strictly prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message and any attachments.[v1.0] From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Thursday, October 19, 2006 6:22 AM To: [EMAIL PROTECTED] Subject: Re: reverse tapering I think we all need to look at why we think bigger is better. These large 5 and 6 Fr caths are causing more thrombosis. What is wrong with the 4fr being the norm. unless we need double lumen caths. I am truly concerned when I read that there is now a triple lumen PICC. This is especially true in the elderly where the veins are smaller.   Raina Pegg RN