Clinical benefit of adding cyanoacrylate glue during PICC line insertion compared to standard procedure in outpatient cancer patients: Results from the randomized prospective trial PICCandGLUE

Abstract

Background: Peripherally inserted central catheters (PICCs) can be used to administer a variety of intravenous therapies to cancer patients. PICC insertion can be associated with bleeding at the puncture site requiring additional care and dressing repairs. Several studies suggest that the addition of cyanoacrylate glue (CAG) at PICC insertion reduces the risk of bleeding and the further need for compresses, as well as catheter-related complications. Methods: This monocenter, randomized, controlled, prospective study was conducted in the vascular access unit (VAU) of the French comprehensive cancer center Léon Bérard. The primary objective was to compare the efficacy of PICC insertion with CAG versus without glue in cancer patients requiring central venous access. Success was defined as the absence of compress requirement at the end of the procedure. Secondary objectives included the number of patients needing a change of dressing within 1 h, at day 8 and at day 30, and the incidence of PICC removal and PICC-related complications in the 30 days following insertion. Results: From August 2023 to July 2024, 98 outpatients were randomized (1:1) in the experimental arm (CAG, n = 48) or in the standard arm (without glue, n = 50). Success occurred in 47 (98%) patients in the CAG arm versus 39 (78%) in the standard arm (p = 0.001). Within the first hour 1 (2%) patient in the CAG arm required a change of dressing compared to 23 (46%) in the standard arm (p < 0.001). During the 30-day follow-up period, no significant differences between the two arms in terms of change of dressing or complications were reported. Conclusion: CAG provides an immediate benefit at the end of PICC insertion that lasts for up to 1 h after the end of the procedure. The use of CAG would improve the organization of the catheter placement unit and reduce the need for post-procedure nursing care.