Catheter-Associated Thrombosis in Patients With Malignancy

Shivakumar, S; Anderson, David R.; Couban, Stephen

doi:10.1200/jco.2009.22.6126

Cited by 75 publications

(79 citation statements)

References 64 publications

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“…1,6,10 This retrospective study is the first to our knowledge to determine the incidence of symptomatic UEVT in patients with cancer and identify the risk factors specifically associated with PICC-related UEVT in this population. Although previous studies have identified PICC-specific qualities that increase UEVT risk, this study also evaluated patient-specific risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of catheter-associated asymptomatic UEVT has been reported to be as high as 66%. 1,6 Although most cases are asymptomatic and of uncertain clinical significance, UEVT can have a significant impact on a patient's health care. Catheters that have lost functioning often need to be replaced at an average cost of approximately $5,000 and can lead to serious morbidity, including recurrent UEVT, postphlebitic syndrome, and pulmonary embolism.…”

Section: Introductionmentioning

confidence: 99%

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Upper Extremity Venous Thrombosis in Patients With Cancer With Peripherally Inserted Central Venous Catheters: A Retrospective Analysis of Risk Factors

Ahn

Illum

Wang

et al. 2013

JOP

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Purpose: Peripherally inserted central catheters (PICCs) are often used in place of mediport catheters because of cost and lack of operating room time and to prevent delays in therapy. One common complication associated with their use is upper extremity venous thrombosis (UEVT). The purpose of this study was to ascertain risk factors associated with an increased risk of PICCassociated UEVT in patients with cancer. Methods Conclusion:Specific factors significantly increase the risk of UEVT in patients with cancer with PICCs, whereas use of APAs seems to have a protective effect against UEVT. These results may aid in the development of a predictive model for identifying patients at high risk of UEVT who may benefit from APAs, as well as in determining preventive strategies for reducing the risk of PICC-associated UEVT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Upper Extremity Venous Thrombosis in Patients With Cancer With Peripherally Inserted Central Venous Catheters: A Retrospective Analysis of Risk Factors

Ahn

Illum

Wang

et al. 2013

JOP

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“…6 Over the past 2 decades, although the use of CVCs has increased dramatically, the risk of CRTs per catheter has decreased, perhaps related to less thrombogenic catheters and improved insertion techniques. 7,8 Although the majority of asymptomatic CRT cases remain subclinical, symptomatic DVT occurs in 1%-5% of patients with a CVC (Table 1). [9][10][11][12] A prospective study of 444 cancer patients with a CVC reported symptomatic, ipsilateral DVT in 4% at a median of 30 days after insertion.…”

Section: Incidence Of Crtmentioning

confidence: 99%

Central venous catheter–related thrombosis

2014

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Thrombotic complications associated with the use of central venous catheters (CVCs) are common and lead to distressing patient symptoms, catheter dysfunction, increased risk of infections, long-term central venous stenosis, and considerable costs of care. Risk factors for catheter-related thrombosis include use of larger, multilumen, and peripherally inserted catheters in patients with cancer receiving chemotherapy. Symptomatic catheter-related thrombosis is treated with anticoagulation, generally without removing the catheter. The intensity and duration of anticoagulation depend on the extent of thrombosis, risk of bleeding, and need for continued use of a CVC. To date, the clinical benefit of prophylactic doses of anticoagulant has been disappointing and these agents are not used routinely for this purpose. This chapter focuses on recent evidence, remaining controversies, and practical approaches to reducing the burden of thrombosis associated with CVCs. Learning Objectives• To identify the types and consequences of catheter-related thrombotic complications in patients with CVCs • To develop an approach to the management of CVC-related thrombosis • To review the evidence on the prevention of CVC-related thrombosis

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“…The existing data are primarily from patients in oncological cohorts for whom the use of repeated cycles of i.v. chemotherapy requires central venous catheter placement (6)(7)(8)(9). In this population, many risk factors for thrombosis have already been identified: hypercoagulability related to prolonged bed rest during repeated hospitalizations, malnutrition, and cancer progression, particularly with metastatic disease.…”

mentioning

confidence: 99%