Introduction

In clinical practice, various types of catheters and insertion techniques are used, which may affect the duration of use, the risk of complications, and patient comfort. They are particularly recommended for patients with difficult intravenous access, where short peripheral catheters require frequent replacement, and there are no absolute indications for central catheter insertion. The two most commonly used types of long peripheral catheters in our centre are the Smartmidline Vygon, inserted using the direct Seldinger technique, and the BullPuP, inserted using the ‘over-the-needle’ method. This study retrospectively compared their use and maintenance.

Material and methods

A retrospective analysis was conducted on 478 patients hospitalized at the Medical University of Warsaw between 2021 and 2024 who had a long peripheral catheter inserted using the Seldinger technique or ‘over-the-needle’ method. Collected data included patient age and sex, indications for insertion, insertion site, catheter type, length and diameter, dwell time, aspiration effectiveness, insertion time, number of attempts, vein diameter before tourniquet, and reasons for removal.

Results

The most common indication was difficult intravenous access combined with therapy exceeding 5 days. Catheter size did not significantly affect dwell or withdrawal times. Completion of therapy was the leading reason for removal. For 4 Fr catheters, mean dwell times were 10.67 days for Smartmidline Vygon (group 1) and 10.75 days for BullPuP (group 2), with similar aspiration performance. Catheters in group 1 were often removed due to occlusion, whereas no such complication occurred in group 2. Catheter length also influenced reasons for removal, including self-removal and suspected infection.

Conclusions

Selecting the appropriate catheter length, diameter, and insertion site is essential for durable intravenous access, minimising complications, and maintaining therapy effectiveness. These findings underscore the importance of individualising clinical decisions and support further research to optimise long peripheral catheter use in hospital practice.