Incidence of ultrasound‐detected asymptomatic long‐term central vein catheter‐related thrombosis and fibrin sheath in cancer patients
- 18 May 2015
- journal article
- clinical trial
- Published by Wiley in European Journal of Haematology
- Vol. 95 (5), 472-479
- https://doi.org/10.1111/ejh.12519
Abstract
Most central venous catheter (CVC)-related deep vein thromboses (DVT) are asymptomatic and their incidence and clinical relevance are still under debate. Data on CVC-related fibrin sheaths are scarce. We investigated the incidence of asymptomatic DVT and fibrin sheaths in cancer patients with long-term CVC implantation who underwent Doppler ultrasound surveillance at 1, 6, and 12 months after implantation. Effects of low-weight molecular heparin (LWMH) therapy on DVT and fibrin sheaths were also analyzed.This prospective study was performed on a large cohort (n = 400) of patients with cancer aged >18 requiring long-term CVC implantation for chemotherapy infusion. CVC was implanted by a trained qualified staff, according to standardized protocol in a specific surgery. Patients underwent ultrasound examination at 1 and 6 months after CVC implantation to detect 'early' (1 month) and 'late' (6 months) asymptomatic DVT or fibrin sheaths incidence. Sixty-nine patients underwent US examination also 12 months after CVC implantation.The incidence of CVC-related thrombosis was 0.10 events per 1000 catheter days. Anticoagulation therapy with LWMH resolved 50% of DVT, but no CVC needed removing. Incidence of new onset fibrin sheaths was 0.71 events per 1000 catheter days. Fibrin sheaths resolution occurred independently of LWMH therapy.The incidence of asymptomatic DVT in our patients with long-term CVC is very low and does not represent per se an indication for removal of functioning CVC in patients with cancer. Fibrin sheaths are frequent (13%) and never associated with CVC dysfunction.Asymptomatic DVT and fibrin sheaths do not represent per se an indication for removal of functioning CVC in cancer patients who need central vein access.Keywords
This publication has 24 references indexed in Scilit:
- Catheter‐associated deep vein thrombosis of the upper extremity in cancer patients: guidance from the SSC of the ISTHJournal of Thrombosis and Haemostasis, 2014
- International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancerJournal of Thrombosis and Haemostasis, 2012
- Risk factors, management and primary prevention of thrombotic complications related to the use of central venous cathetersVasa, 2012
- Catheter-Associated Thrombosis in Patients With MalignancyJournal of Clinical Oncology, 2009
- Management of occlusion and thrombosis associated with long-term indwelling central venous cathetersThe Lancet, 2009
- Thrombotic and infectious complications of central venous catheters in patients with hematological malignanciesAnnals of Oncology, 2007
- Ultrasound-Guided Internal Jugular AccessSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2007
- Incidence, Risk Factors, and Outcomes of Catheter-Related Thrombosis in Adult Patients With CancerJournal of Clinical Oncology, 2006
- Deep vein thrombosis associated with central venous catheters – a reviewJournal of Thrombosis and Haemostasis, 2005
- Venous Thromboembolism Associated With Long-Term Use of Central Venous Catheters in Cancer PatientsJournal of Clinical Oncology, 2003