Venous Thrombosis Related to Peripherally Inserted Central Catheters

Grove, Jay R.; Pevec, William C.

doi:10.1016/s1051-0443(07)61797-7

Cited by 219 publications

(122 citation statements)

References 4 publications

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“…8) Nonetheless, one report concluded that catheter diameter plays an important role in catheter-related DVT in the brachial vein. 23) In our study, we found that age, sex, height, body weight, venous diameter, multiple sheath placement, heparinization, and procedure time all failed to have a significant influence on venous thrombosis. Successful prediction of DVT development after multiple sheath placement in a single femoral vein still needs further investigation.…”

Section: Discussionmentioning

confidence: 60%

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

et al. 2004

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SUMMARYMultiple intracardiac catheters are often necessary for electrophysiological study (EPS) and radiofrequency (RF) ablation therapy. Therefore, multiple venous sheath placement in one femoral vein is always required for multiple intracardiac catheter insertion. The vascular complications incurred by placement of multiple sheaths have not been fully studied. We utilized duplex ultrasonography to assess the femoral veins before and after the procedure. This study consisted of 52 patients (68 femoral veins) who underwent EPS and RF ablation therapy. Up to three sheaths were inserted into a single femoral vein. Nonocclusive deep vein thrombosis (DVT) occurred in 12/68 veins (17.6%) of 11 patients on the day following the procedure. Thrombosis regressed spontaneously in 11 veins and persisted in 1 vein at 1-week follow-up. The venous diameter significantly decreased the day after the procedure (8.7 ± 1.2 mm vs 5.3 ± 1.5 mm, P < 0.001), but recovered by the 1-week follow-up (7.9 ± 1.7 mm, P = 0.07) in the 12 veins. Short-term placement of multiple venous sheaths in a single femoral vein appears to be safe. Nonetheless, nonocclusive DVT does occur in a significant number of patients. Although thrombosis regressed and the outcome appeared to be benign in most patients, close follow-up to avoid potential vascular complications is necessary. (Jpn Heart J 2004; 45: 257-264)

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Section: Discussionmentioning

confidence: 60%

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

et al. 2004

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“…17 VADs of small caliber should be employed to minimize the risk of catheter-related thrombosis and/or subsequent venous stenosis. 25 This is particularly true for PICCs, 26 although it may be difficult to administer blood products or highflow hydration with a very narrow lumen. When a totally implanted port is used, choosing a catheter caliber larger than 6 to 7 French does not carry significant advantages since the main limitation to flow is the caliber of the Huber needle used to access the port.…”

Section: Catheter Design and Materialsmentioning

confidence: 99%

Vascular Access in Oncology Patients

Gallieni

Pittiruti

Biffi

2008

CA: A Cancer Journal for Clinicians

253

166

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Adequate vascular access is of paramount importance in oncology patients. It is important in the initial phase of surgical treatment or chemotherapy, as well as in the chronic management of advanced cancer and in the palliative care setting. We present an overview of the available vascular access devices and of the most relevant issues regarding insertion and management of vascular access. Particular emphasis is given to the use of ultrasound guidance as the preferred technique of insertion, which has dramatically decreased insertion-related complications. Vascular access management has considerably improved after the publication of effective guidelines for the appropriate nursing of the vascular device, which has reduced the risk of late complications, such as catheter-related bloodstream infection. However, many areas of clinical practice are still lacking an evidence-based background, such as the choice of the most appropriate vascular access device in each clinical situation, as well as prevention and treatment of thrombosis. We suggest an approach to the choice of the most appropriate vascular access device for the oncology patient, based on the literature available to date. (CA Cancer J Clin 2008;58:323-346.)

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“…16 Limited information is available pertaining to the incidence of thrombotic complications associated with peripherally inserted central catheter (PICC) access. Estimates vary widely, from 0.3% 17,18 to 56%, 18 with the largest retrospective reviews supporting incidence rates of 2.5% and 3.9% (2,063 and 813 PICC insertions, respectively), confirmed by ultrasound 19,20 and/ or venography. 19 In a multivariate analysis, Grove et al 20 noted that only catheter diameter was predictive of thrombosis, with thrombosis rates of 1%, 6.6%, and 9.8% for 4-French (F), 5-F, and 6-F catheters, respectively.…”

Section: Central Venous Catheter-related Thrombosismentioning

confidence: 99%

“…Estimates vary widely, from 0.3% 17,18 to 56%, 18 with the largest retrospective reviews supporting incidence rates of 2.5% and 3.9% (2,063 and 813 PICC insertions, respectively), confirmed by ultrasound 19,20 and/ or venography. 19 In a multivariate analysis, Grove et al 20 noted that only catheter diameter was predictive of thrombosis, with thrombosis rates of 1%, 6.6%, and 9.8% for 4-French (F), 5-F, and 6-F catheters, respectively. Chemaly et al 19 noted a time-dependent relationship to PICC-associated thrombosis with 34%, 55%, and 75% of events occurring by the end of the first, second, and third weeks after insertion, respectively.…”

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

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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.

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Venous Thrombosis Related to Peripherally Inserted Central Catheters

Cited by 219 publications

References 4 publications

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

Safety and Outcomes of Short-Term Multiple Femoral Venous Sheath Placement in Cardiac Electrophysiological Study and Radiofrequency Catheter Ablation

Vascular Access in Oncology Patients

A critical review of thromboembolic complications associated with central venous catheters

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