Epidemiology and prevention of upper limb thrombosis in patients with central venous catheters


Intravenous literature: Lee, A.Y. and Kamphuisen, P.W. (2012) Epidemiology and prevention of catheter-related thrombosis in patients with cancer. Journal of Thrombosis and Haemostasis. Jun 15. [Epub ahead of print].


Central venous catheters are extensively used in patients with cancer to secure delivery of chemotherapy and facilitate phlebotomy. Unfortunately, considerable morbidity can result from early complications or late sequelae, ranging from arterial puncture, pneumothorax, bloodstream infections, to catheter-related thrombosis (CRT). Contemporary studies have shown that the incidence of symptomatic CRT is approximately 5% while the incidence of asymptomatic CRT is higher at 14 – 18%. The significance and mechanisms of catheter design, material, insertion location and technique, position of the catheter tip, and other risk factors in contributing to the development of CRT are not well understood. Efforts to reduce thrombotic complications, involving flushing the catheter with heparinized solutions, using heparin-bonded catheters, and systemic anticoagulant prophylaxis have largely been ineffective. More studies are needed to understand the pathophysiology of thrombotic complications to help identify effective interventions to reduce this adverse outcome.

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