Safety and efficacy of mini midline and peripheral venous catheters in intravenous therapy: a systematic review and meta-analysis

Background Peripheral intravenous catheters (PIVCs) are the most commonly used devices for intravenous therapy (IVT), and mini midlines (MMCs) have emerged as a promising alternative. This study conducted a systematic review and meta-analysis to compare the safety and efficacy of MMCs and PIVCs in IVT patients. Methods This study comprehensively searched Web of Science, PubMed, Embase, SinoMed, CNKI, Wanfang Data, VIP and the Cochrane Library from inception to June 30th, 2025, for randomized controlled trials (RCTs) comparing MMCs and PIVCs. The Cochrane RoB 2 tool assessed bias risk, with outcome measures including one-time puncture success rate, operation time, puncture times, retention time, catheter-related complication incidence and complication-induced tube removal rate. Results A total of 9 RCTs involving 1175 patients were included. Compared with PIVCs, MMCs had a significantly higher one-time puncture success rate and fewer punctures (both P<0.00001), as well as longer operation and retention times ( P < 0.01). MMCs also showed a markedly lower incidence of catheter-related complications (e.g., phlebitis, thrombosis) and complication-induced tube removal rate (P<0.00001). Conclusion This meta-analysis of RCTs confirms that MMCs are superior to PIVCs in terms of puncture performance, retention characteristics and safety for IVT patients.