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"In patients with EC, secPICC and right-sided placement reduce perioperative venous thrombus formation" Nanishi et al (2021).

Antithrombotic peripherally inserted central catheter


Purpose: Although a central venous catheter (CVC) is often needed perioperatively for intraoperative and nutritional management of esophageal cancer (EC), the catheter placement impacts the risk of venous thrombosis. We examined the risks of thrombus formation by catheter type, placement, and duration.

Methods: In total, 226 patients with EC were enrolled in this retrospective study. Patients were classified into one of three groups: those with a conventional CVC (cCVC), a peripherally inserted central catheter (PICC), or an antithrombogenic agent-coated PICC (secPICC). The thrombus formation and clinicopathological features were examined.

Results: The frequency of all types of thrombosis was significantly lower in the secPICC group (p < 0.01). Although deep vein thrombosis was frequent in the cCVC group, catheter thrombosis was frequent in the PICC group. In a univariate analysis in patients with the PICC and secPICC groups, less thrombus formation was observed in the secPICC (p = 0.01), short placement time (p = 0.02), and right-sided placement (p < 0.01). Furthermore, a multivariate analysis revealed that secPICC (p = 0.049) and right-sided placement (p = 0.04) significantly reduced rates of thrombus formation.

Conclusion: In patients with EC, secPICC and right-sided placement reduce perioperative venous thrombus formation.


Nanishi K, Konishi H, Shiozaki A, Fujiwara H, Ohashi T, Shimizu H, Arita T, Kubota T, Okamoto K, Otsuji E. Reduction of perioperative venous thrombus formation by antithrombotic peripherally inserted central catheter in esophageal cancer. Langenbecks Arch Surg. 2021 Nov 2. doi: 10.1007/s00423-021-02367-7. Epub ahead of print. PMID: 34729630.