Catheter‐related thrombosis in cancer patients

Abstract

SummaryCentral venous catheters are commonly used in haematology departments for the administration of chemotherapy, blood products and parenteral nutrition in patients with haematological malignancy. Thrombosis is a recognized complication of such devices especially in oncology patients. Catheter-related thrombi (CRT) may lead to pulmonary embolism and infection, as well as catheter failure and potential delays in treatment. The vast majority of CRT are asymptomatic, thus a high index of suspicion is required in making the diagnosis. Doppler ultrasound or venography may be employed to identify CRT. Once confirmed, the initiation of treatment is a balance between the risks of anticoagulation against potential complications of CRT. A number of risk factors for CRT are discussed along with an overview of catheter types, their appropriate choice and intravascular positioning.

Risk of site-specific cancer in incident venous thromboembolism: A population-based study

“…[3, 47–50] However, of the 33 incident cases with active lymphoma and 18 incident cases with active leukemia, only 14 of 50 (28%) had a central venous catheter within the three months prior to the VTE event (1 case had both active lymphoma and active leukemia at the time of the incident VTE), and only 12 of 50 (24%) events were arm DVT. All 18 incident cases with active leukemia had resided in Olmsted County for at least one year prior to the venous thromboembolism event.…”

A RIETE registry analysis of recurrent thromboembolism and hemorrhage in patients with catheter-related thrombosis

“…Eight percent of patients presented with a CRT and PE in our series, which is consistent with other reports in the literature. 27,28 This is significantly less than lower extremity DVT, though, as 16% to 30% of patients with DVT will present with PE. 29 Whether type of thrombosis at presentation has an impact on the risk of recurrent thrombotic event is debated in the literature.…”

The Incidence of Peripherally Inserted Central Catheter Symptomatic Pulmonary Embolism after Line Removal: A Retrospective Analysis

“…The incidence of symptomatic PE as a complication of UEDVT is approximately 9 to 12%, of which less than one percent results in fatal PE [26][27][28]. The overall incidence of PICC associated UEDV has been reported to be from 0 to 56% due to the heterogeneity of study conditions [26].…”