Post‐thrombotic syndrome after central venous catheter removal in childhood cancer survivors: A prospective cohort study

Abstract

PTS post-CVC removal in pediatric cancer survivors is not a rare event. The association between PTS and the history of CVC occlusion confirms earlier findings, and suggests that CVC occlusion may indicate asymptomatic DVT. PTS is also associated with lower HRQoL scores highlighting the need to study preventive measures, especially for high risk groups. Pediatr Blood Cancer 2015;62:285-290. © 2014 Wiley Periodicals, Inc.

BSH Guideline: management of thrombotic and haemostatic issues in paediatric malignancy

“…The decision to anticoagulate a child with a CVL‐related thrombosis is influenced by the presence of symptoms, the risk of progression or embolisation and the desire to reduce the risk of post‐thrombotic syndrome (Polen et al , ). International guidelines recommend treatment of symptomatic CVL‐related VTE in children with 3 months of anticoagulation (Chalmers et al , ; Monagle et al , ; Debourdeau et al , ).…”

“…The decision to anticoagulate a child with a CVL-related thrombosis is influenced by the presence of symptoms, the risk of progression or embolisation and the desire to reduce the risk of post-thrombotic syndrome (Polen et al, 2015).…”

“…Given the reported high rates of incidental thrombosis solely related to a CVL, an alternative approach in this subgroup, particularly where the age of the event is unclear, is to monitor with repeat imaging and only anticoagulate if extension of the thrombus occurs or the patient subsequently becomes symptomatic. However, post‐thrombotic syndrome is described in childhood cancer survivors with previous asymptomatic CVL‐related thrombosis (Ruud et al , ; Polen et al , ) and may favour treatment if the thrombosis is thought to be a recent event.…”

Venous Thromboembolism in Children with Cancer and Blood Disorders

“…PTS occurred in 30.5–34% of patients depending on the method of diagnosis. A history of CVC occlusion, DVT, or multiple CVC placements was associated with PTS ( 35 ).…”

Central venous catheter‐related thrombosis and thromboprophylaxis in children: a systematic review and meta‐analysis: discussion

“…These data indicate that asymptomatic and symptomatic DVT have comparable risks for CVC loss, owing to significant venous occlusion. In addition, long‐term sequelae, such as post‐thrombotic syndrome, have been observed at comparable frequencies after asymptomatic DVT and symptomatic DVT by several studies .…”