![]() 1,8,9 Most notably, pH alone is no longer an indication for the use of a central line. The midline market is expected to gain additional momentum from the release of the INS’s 2016 Infusion Nursing Standards of Practice, which, relative to previous editions, includes reduced limitations on drugs and solutions administered through midlines. ![]() 7 Use of the MAGIC assessment tool is expected to increase over the next seven years, driving a shift in vascular access device usage from PICCs to midlines. 6 A recent application of the MAGIC assessment tool in one facility yielded a 35 percent decline in monthly PICC insertions, while monthly midline insertions almost tripled. Released in September 2015, the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) is a collection of guidelines providing recommendations as to when one vascular access device is preferable to another. While reimbursement changes have shaped the trajectory of the midline market in recent years, future growth will be driven by the adoption of recently published appropriate usage guidelines from the University of Michigan and the INS. Midlines, with an estimated infection rate well below that of PICCs, have come into vogue, offering an attractive alternative to PICCs in select cases. 2,3 In the wake of this decision, healthcare providers have placed increased weight on selecting the vascular access catheter with the lowest associated infection rate. In 2008, CMS discontinued payment for the estimated $32,000 cost tied to treating a central line-associated blood stream infection. The uptick in midline insertions is exerting downward pressure on PICC sales, which, in turn, is contributing to moderation in the tip-placement device market. However, recent initiatives from the Centers for Medicare and Medicaid Services (CMS), as well as new appropriate usage guidelines from the University of Michigan and Infusion Nursing Society (INS), are driving a surge in midline use. Traditionally, midlines have occupied a niche market between peripherally inserted central catheters (PICCs) and peripheral intravenous catheters (PIVCs). Midline catheters are used to obtain short- to intermediate-term peripheral venous access for infusing intravenous fluids and medication. Since each subspecialty brings unique expertise and experience to the field, this handbook will be a valuable resource for all physicians currently working in peripheral vascular interventions.By Kamran Zamanian, Ph.D., and Sean Collins, iData Research Inc. Yerem Yeghiazarians (Division of Interventional Cardiology), from the University of California San Francisco School of Medicine, the Handbook of Endovascular Peripheral Interventions is a collaborative effort between cardiologists, vascular surgeons, and radiologists. ![]() Owens (Division of Vascular Surgery) and Dr. These invaluable pearls are provided by contributing chapter authors who are experts in the field.Įdited by Dr. Importantly, Tips of the Trade and How I Do It sections within each chapter make the handbook practical for daily use. Covering all aspects of percutaneous peripheral vascular interventions, each chapter of this highly illustrated book provides a brief background, etiology, clinical presentation, imaging, and percutaneous treatment of different vascular conditions. The Handbook of Endovascular Peripheral Interventions has been written to serve as a comprehensive guide for both the beginner and advanced interventionalist. ![]()
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