Right atrial thrombi are related to indwelling central venous catheter position: Insights into time course and possible mechanism of formation

Gilon, Dan; Schechter, David Chas.; Rein, Azaria J.J.T.; Gimmon, Zvi; Or, Reuven; Rozenman, Yoseph; Slavin, Shimon; Gotsman, Mervyn S.; Nagler, Arnon

doi:10.1016/s0002-8703(98)70322-9

Cited by 124 publications

(91 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In one study, the incidence of right heart mural thrombi (Innominate-superior vena cava, superior vena cava-RA, and RA) on postmortem inspection of 141 consecutive patients with CVC was 29%. 22 A more conservative estimate of RHTE (12.5%) was found by Gilon et al 23 in a prospective study of 55 patients who were followed for up to six to eight weeks after CVC insertion. The authors found that RHTE were significantly associated with a catheter tip in the RA, and that concurrent infection, malignancy, procoagulant states, and structural abnormalities were risk factors for development of CVC-related RAT.…”

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 94%

See 1 more Smart Citation

A critical review of thromboembolic complications associated with central venous catheters

Burns

McLaren

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Central venous catheters (CVC) are commonly used in critical care. While thrombosis is a well-recognized and frequent complication associated with their use, CVC-related thromboembolic complications, including pulmonary embolism (PE) and right heart thromboembolism (RHTE), occur less frequently and often evade diagnosis. Little information exists to guide clinicians in the diagnosis and management of CVC-related thromboembolic complications. Source:We critically review and synthesize the literature highlighting the incidence of CVC-related thrombosis. We highlight the risk for developing thromboembolic complications and provide approaches to diagnosing and managing RHTE. Principle findings:The incidence of CVC-related thrombosis varies depending on patient, site, instrument, and infusaterelated factors. Central venous catheters-related thrombosis represents an important source of morbidity and mortality for affected patients. Pulmonary embolism occurs in approximately 15% of patients with CVC-related upper extremity deep venous thrombosis (UEDVT). More frequent use of transesophageal echocardiography, in patients with suspected and confirmed PE, has resulted in increased detection of RHTE. While it is recognized that the occurrence of RHTE, in association with PE, increases mortality, the optimal strategy for their management has not been established in a clinical trial. Conclusion:Central venous catheter-related thrombosis occurs frequently and represents an important source of morbidity and mortality for affected patients. Our review supports that surgery and thrombolysis have both been demonstrated to enhance survival in patients with RHTE and PE. However, important patient, clot, and institutional considerations mandate that treatment for patients with RHTE and PE be individualized.

show abstract

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 94%

“…The authors found that RHTE were significantly associated with a catheter tip in the RA, and that concurrent infection, malignancy, procoagulant states, and structural abnormalities were risk factors for development of CVC-related RAT. 23 …”

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 99%

A critical review of thromboembolic complications associated with central venous catheters

Burns

McLaren

2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…9 In this case, catheter tip location in the RA may have been a predisposing factor for thrombus formation, owing to catheter irritation of the RA endocardium. 10,11 In addition, our patient presented several risk factors for fungemia, including diabetes mellitus, renal failure, hemodialysis, and previous antibiotic exposure. 12 The most common complication of fungal endocarditis is embolism (as seen in our patient), although congestive heart failure, sepsis, and other complications have also been reported.…”

Section: Discussionmentioning

confidence: 85%

Unusual cause of superior vena cava syndrome diagnosed with transesophageal echocardiography

Barbeito

Bar-Yosef

Lowe

et al. 2008

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…right atrium) of the tip of the catheter. 21,22 Despite limitations in the number of patients, studies have provided supportive evidence for an association between thrombus formation and thrombophilia. 23,24 Although most of the patients with CRAT are not routinely examined with regard to hypercoagulability factor, certain acquired or hereditary factors have been described in those who have been tested.…”

Section: Discussionmentioning

confidence: 99%

Catheter-related atrial thrombus: tip of the iceberg?

et al. 2015

View full text Add to dashboard Cite

Although guidelines recommend catheters as a last resort for establishing a vascular access in patients undergoing dialysis, they continue to be used widely for this purpose. Catheter-related atrial thrombus (CRAT) is rarely reported in this group of patients, and it can lead to serious complications. The aim of this study was to determine the incidence of CRAT in patients undergoing hemodialysis with permanent-tunneled catheters. A total of 50 patients undergoing hemodialysis with permanent catheters were included in this study. The diagnosis of CRAT was based on transthoracic echocardiography findings. Thrombus was present in nine patients (18%) and related to the tip of the catheter in all cases. Except for one patient with two foci of thrombus, all patients had a single focus. There were no significant associations between the development of thrombus and the duration of catheter use or the location of the catheter. Furthermore, catheter-related atrial thrombus did not appear to have a significant effect on mortality. The asymptomatic character of CRAT can be responsible for the low reporting rates, and its exact role in increased mortality and morbidity related with catheter use remains unknown. While planning management strategies, information on different options for vascular access routes and possible catheter-related complications should be provided to all patients who will undergo dialysis, together with a discussion involving other replacement alternatives for end-stage renal disease.

show abstract

Right atrial thrombi are related to indwelling central venous catheter position: Insights into time course and possible mechanism of formation

Cited by 124 publications

References 23 publications

A critical review of thromboembolic complications associated with central venous catheters

A critical review of thromboembolic complications associated with central venous catheters

Unusual cause of superior vena cava syndrome diagnosed with transesophageal echocardiography

Catheter-related atrial thrombus: tip of the iceberg?

Contact Info

Product

Resources

About