Reverse tapered versus non-tapered peripherally inserted central catheters: A narrative review

Introduced over 20 years ago, the reverse tapering design for PICC catheters is supposed to have some benefits in terms of both efficacy and safety. In particular, it would ensure less postoperative bleeding at the exit site and greater effectiveness in preventing kinking or twisting of the same. Since its introduction, these hypothesized advantages have never been demonstrated in clinical studies, however very scarce, which have highlighted neither advantages nor disadvantages of reverse tapered catheters when compared to non-reverse tapered ones. This narrative review analyzes some aspects of the use of reverse tapered PICCs, also paying attention to some possible undesirable effects that have arisen from the introduction into clinical practice of new subcutaneous systems of securement of PICCs to the skin. Clinicians should be aware of the fact that reverse tapering design does not represents a sure improvement in terms of safety and efficacy of PICCs and its adoption should be weighed against possible clinical disadvantages.