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Systems that use the heart's electrical signal and a magnetic tracker to show where the tip of a PICC line is while it is being put in, so most patients do not need a chest X-ray afterwards before the line can be used.
NICE medical technologies guidance MTG24, now HealthTech guidance HTG368 (published 25 March 2015, updated 30 May 2019), says the case for adopting the Sherlock 3CG Tip Confirmation System "is supported by the evidence" and that it "usually avoids the need for a confirmatory chest X-ray in patients who would otherwise have blind insertion". It recommends it be considered for adults, noting that patients whose electrocardiogram shows no P wave, for example with atrial fibrillation, still need a chest X-ray. The Sherlock 3CG tip positioning stylet was most recently cleared in the United States in 2022 (K222232, Bard Access Systems). Piccolo Medical's SmartPICC system, an ECG-guided navigation system, was cleared on 22 January 2021 (K200037).
A stylet in the catheter acts as an intracavitary ECG lead: the P wave grows as the tip approaches the junction of the superior vena cava and right atrium, while a magnetic sensor on the chest tracks the tip's path.
Query for this technology: (TITLE:"PICC tip location systems" OR ABSTRACT:"PICC tip location systems" OR TITLE:"Sherlock 3CG, SmartPICC" OR ABSTRACT:"Sherlock 3CG, SmartPICC" OR TITLE:"Tip confirmation system" OR ABSTRACT:"Tip confirmation system" OR TITLE:"ECG-guided PICC placement" OR ABSTRACT:"ECG-guided PICC placement") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about PICC tip location systems (Sherlock 3CG, SmartPICC), not a curated reading list.
Shares Peripherally inserted central catheters (PICC lines), Infusion pumps, ports, and ambulatory chemotherapy devices, Central venous access (port, PICC line) and the tag devices-gaps-2026-11.
Shares Peripherally inserted central catheters (PICC lines), Infusion pumps, ports, and ambulatory chemotherapy devices, Central venous access (port, PICC line) and the tag devices-gaps-2026-11.
Shares BD (Becton, Dickinson and Company), Infusion pumps, ports, and ambulatory chemotherapy devices, Central venous access (port, PICC line) and the tag devices-gaps-2026-11.
Shares Peripherally inserted central catheters (PICC lines), Infusion pumps, ports, and ambulatory chemotherapy devices, Central venous access (port, PICC line) and the tag devices-gaps-2026-11.
Shares Peripherally inserted central catheters (PICC lines), BD (Becton, Dickinson and Company), Infusion pumps, ports, and ambulatory chemotherapy devices, Central venous access (port, PICC line) and the tag devices-gaps-2026-11.
Shares Peripherally inserted central catheters (PICC lines), Infusion pumps, ports, and ambulatory chemotherapy devices and the tag devices-gaps-2026-11.
Shares BD (Becton, Dickinson and Company) and the tag devices-gaps-2026-11.
Shares BD (Becton, Dickinson and Company) and the tag devices-gaps-2026-11.
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