Implantable port thrombosis in cancer patients: a monocentric experience

Dridi, M.; Mejri, Nesrine; Labidi, Soumaya; Afrit, Mehdi; Benna, Houda El; Miled, K. Ben; Boussen, Hamouda

doi:10.20892/j.issn.2095-3941.2016.0057

Cited by 7 publications

(16 citation statements)

References 25 publications

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“…The rate of IVAD-related UEDVT is low at 1.29% (95% CI 0.2%-2.4%) in our study. Our reported rate of IVAD-related UEDVT seems lower than previously reported rates [8,10,16]. In a recent study including 600 cancer patients, 5.5% had IVAD-related DVT [16].…”

Section: Discussioncontrasting

confidence: 80%

“…Similarly, we reported a higher rate of IVAD-related UEDVT (4.5%, 95% CI, 2.5 to 6.3%) with a different IVAD. In both studies, the majority of patients were diagnosed with breast cancer or colorectal cancer [10,16]. A recently published prospective cohort study examining the rate of IVAD related VTE in 3032 patients across France found a rate of 3.8% [15].…”

Section: Discussionmentioning

confidence: 99%

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Implanted vascular access device related deep vein thrombosis in oncology patients: A prospective cohort study

Suleman

Jarvis

Hadziomerovic

et al. 2019

Thrombosis Research

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A B S T R A C TBackground: Implanted vascular access devices (IVADs) have significantly improved the management of cancer patients. These patients are at an increased risk of venous thromboembolism and IVADs are a known risk factor. We sought to assess the incidence of IVAD-related upper extremity deep vein thrombosis (IVAD-related UEDVT) associated with BioFlo® IVADs (Angiodynamics, Inc.). Methods: A total of 394 cancer patients were enrolled over 12 months. The primary outcome was the incidence of IVAD-related UEDVT confirmed by diagnostic imaging. IVAD-related UEDVT was defined as symptomatic ipsilateral upper extremity (axillary vein or proximal) deep vein thrombosis and symptomatic pulmonary embolism (PE). Patients were followed until initiation of therapeutic anticoagulation, catheter removal, death, or up to 12 months. Results: 389 patients were included in the analysis. The median age of the cohort was 58.2 years; 68% (n = 273) were females. Sixty-six percent had gastrointestional cancer (including pancreatic cancer) and 68% had metastases. Eighty four percent of IVADs were right sided insertions. Ninety eight percent of catheter tip placements were distal superior vena cava (n = 237), cavo-atrial junction (n = 67) or atrium (n = 90). Overall, 5 patients had symptomatic IVAD-related UEDVT (1.29%, 95% CI 0.2 to 2.4%). Conclusion: IVAD-related UEDVT is an infrequent complication in cancer patients with BioFlo® IVADs.Prevention of an IVAD-related UEDVT in the oncology population is crucial. Some IVADs are constructed with catheter tubing composed of a novel anti-thrombogenic polymer which has been shown in in-vitro to reduce thrombus accumulation [12]. We sought to assess the incidence of IVAD-related UEDVT associated with BioFlo® IVADs (Angiodynamics, Inc.) constructed with this material. Methods SettingWe conducted a prospective cohort study of consecutive cancer patients receiving an IVAD for the administration of chemotherapy between August 2015 and September 2017 at The Ottawa Hospital. The

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Implanted vascular access device related deep vein thrombosis in oncology patients: A prospective cohort study

Suleman

Jarvis

Hadziomerovic

et al. 2019

Thrombosis Research

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“…First introduced in 1982, totally implanted venous access ports (TIVAPs) were extensively used in oncologic patients. These devices have been used as a safe method for avoiding venous injury and improving the quality of life for cancer patients (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…Major complications after placement of the TIVAP include infection, thrombosis, catheter migration, occlusion, and central vein stenosis (6). Among these, venous thrombosis is the second major complication associated with TIVAPs after infection (5). Venous thrombosis caused by TIVAPs has been associated with high morbidity and additional costs (5).…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

2020

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Background: The incidence of venous thrombosis based on access route after implantation of the totally implanted venous access port (TIVAP) is controversial. Symptomatic TIVAP-related venous thrombosis remains relatively rare. However, characteristics of symptomatic axillary vein thrombosis after TIVAP implantation via access of the axillary vein has not been reported. Objectives: In this historical cohort study, the incidence and characteristics of venous thrombosis associated with TIVAP via the axillary vein in cancer patients were evaluated. Patients and Methods: A total of 4,773 TIVAPs were placed via the axillary vein in patients with various types of cancer between May 2012 and July 2018. Eighteen patients experienced symptomatic venous thrombosis associated with TIVAPs. Radiologic findings for venous thrombosis were evaluated using computed tomography (CT) including scans of the axillary vein. Medical records were retrospectively reviewed. Results: The prevalence of symptomatic thrombosis was 0.38% (18/4,773). The patients with symptomatic venous thrombosis included 14 males and four females. Among the 18 patients, the most common types of cancer were lung cancer (n = 7) and pancreatic cancer (n = 4), with the incidence rates of 0.79% (lung cancer, 7/882) and 1.58% (pancreatic cancer, 4/253), respectively. The median time between placement of the TIVAP and diagnosis of thrombosis was 35.5 days (range: 6 - 292 days). All symptomatic patients had thrombosis in the axillary vein on CT images. Symptoms were improved in all patients with treatment including removal of TIVAP at the time of diagnosis and following anticoagulation therapy. From the multiple binary logistic regression, pancreatic cancer and lung cancer were statistically significant risk factors of symptomatic axillary vein thrombosis. Conclusion: After insertion of TIVAPs through the axillary vein, symptomatic axillary vein thrombosis rarely developed. Pancreatic cancer and lung cancer were associated with the risk of symptomatic axillary vein thrombosis.

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Characteristics and predictors of venous thrombosis recurrence in patients with cancer and catheter‐related thrombosis

Lipe

Qdaisat

Rajha

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background Central venous catheters raise the risk of catheter‐related thrombosis (CRT) in patients with cancer, typically affecting the upper extremity. Management of CRT involves catheter removal and anticoagulation. However, robust evidence is lacking on the optimal timing of anticoagulation relative to catheter removal. Objectives Our goal is to provide a better understanding of the factors that increase the risk of recurrent venous thromboembolism (VTE) in these patients. Patients and Methods We conducted a retrospective chart review of all consecutive patients with cancer in our hospital affected by CRT between January 1, 2015, and December 31, 2017. We measured recurrence of VTE as thrombosis in any vascular bed or pulmonary embolism, for up to 2 years after diagnosis. Logistic and competing risk regression analyses were used to determine the association between different clinical factors and any VTE recurrence in patients with cancer and CRT. Results Of the 257 individuals meeting the inclusion criteria, 80.2% had their catheter removed; of these, 50.5% did not receive anticoagulation before the removal. Patients who did not receive anticoagulation before the removal had increased 3‐month and 1‐year risks of recurrent VTE (odds ratio, 5.07 [95% confidence interval [CI], 1.53–23.18]; and hazard ratio, 3.47 [95% CI, 1.34–9.01]), respectively. Conclusions Our study supports the use of anticoagulants before catheter removal in patients with CRT. Randomized clinical trials are recommended to establish stronger evidence pertaining to the long‐term risk of VTE recurrence and the effect of catheter reinsertion.

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Implantable port thrombosis in cancer patients: a monocentric experience

Cited by 7 publications

References 25 publications

Implanted vascular access device related deep vein thrombosis in oncology patients: A prospective cohort study

Implanted vascular access device related deep vein thrombosis in oncology patients: A prospective cohort study

Characteristics of Symptomatic Axillary Vein Thrombosis After Placement of Totally Implanted Venous Access Port in Cancer Patients

Characteristics and predictors of venous thrombosis recurrence in patients with cancer and catheter‐related thrombosis

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