Thrombus and thrombosis in cancer patients with permanent venous catheters

2000 ◽  
Vol 20 (03) ◽  
pp. 143-145
Author(s):  
H. D. Bruhn ◽  
F. Gieseler
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Clinical Studies ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Vascular Lumen ◽  
Additive Risk ◽  
Thrombotic Complications ◽  
Port Systems ◽  
Central Catheters

SummaryCancer patients have additive risk factors for thrombosis especially if permanent central catheters (port systems) are used for the delivery of chemotherapy. In our hospital the rate of thrombotic complications is below 5% for cancer patients receiving chemotherapy via port systems. This is in contrast to clinical studies, which have shown that up to 60% of catheters acquire clots that obstruct more than 50% of the vascular lumen. It is reasonable to believe that complications arising from thrombotic catheter alterations, such as bacterial hosting or micro-emboli, are clinically underestimated. The identification of thrombotic alterations of permanent central venous catheters in cancer patients receiving chemotherapy is substantial for the estimation whether anticoagulation strategies should be used as prophylaxis.

Risk factors, management and primary prevention of thrombotic complications related to the use of central venous catheters

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 319-332 ◽  
Author(s):  
Linnemann ◽  
Lindhoff-Last
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Vein Thrombosis ◽  
Palliative Care Setting ◽  
Thrombotic Complications ◽  
Randomised Controlled ◽  
Deep Vein

An adequate vascular access is of importance for the treatment of patients with cancer and complex illnesses in the intensive, perioperative or palliative care setting. Deep vein thrombosis and thrombotic occlusion are the most common complications attributed to central venous catheters in short-term and, especially, in long-term use. In this review we will focus on the risk factors, management and prevention strategies of catheter-related thrombosis and occlusion. Due to the lack of randomised controlled trials, there is still controversy about the optimal treatment of catheter-related thrombotic complications, and therapy has been widely adopted using the evidence concerning lower extremity deep vein thrombosis. Given the increasing use of central venous catheters in patients that require long-term intravenous therapy, the problem of upper extremity deep venous thrombosis can be expected to increase in the future. We provide data for establishing a more uniform strategy for preventing, diagnosing and treating catheter-related thrombotic complications.

Open- vs Closed-Tip Valved Peripherally Inserted Central Catheters and Midlines: Findings from a Vascular Access Database

2015 ◽  
Vol 20 (3) ◽  
pp. 169-176 ◽  
Author(s):  
Pietro Antonio Zerla ◽  
Antonio Canelli ◽  
Giuseppe Caravella ◽  
Alessandra Gilardini ◽  
Giuseppe De Luca ◽  
...  
Keyword(s):  
Vascular Access ◽  
Cost Reduction ◽  
Infectious Complications ◽  
Central Venous Catheters ◽  
Blood Component ◽  
Central Venous ◽  
Vascular Access Devices ◽  
Care Workers ◽  
Thrombotic Complications ◽  
Central Catheters

Abstract Today's patients are more complex in terms of comorbidities and other conditions requiring multiple, long-lasting therapies such as chemotherapy, total parenteral nutrition, blood transfusion or blood component infusions, and frequent blood sampling. The use of central venous catheters represents an important aspect of care for many patients. It is essential to inform health care workers of the risks associated with central venous catheters such as systemic and infectious complications, mechanical complications, and/or thrombotic complications. To maintain monitoring of our peripherally inserted central catheter team's activity, we developed and adopted a database in which all the data regarding each catheter are recorded. By doing that, we have improved catheter management, clinical efficiency, as well as achieved a cost reduction. We implanted 1416 vascular access devices in 1341 patients of both sexes (632 male and 709 female) for a total of 135,778 vascular access device-implant days between March 2010 and December 2013 for several indications. We have followed-up total complications and we correlated them with the need for catheter removal. The results were that open-tipped catheters resulted in both more complications and a greater need for removal.

scholarly journals Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2070
Author(s):  
Alice Labianca ◽  
Tommaso Bosetti ◽  
Alice Indini ◽  
Giorgia Negrini ◽  
Roberto Francesco Labianca
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Central Venous Catheters ◽  
Thromboembolic Events ◽  
Efficacy And Safety ◽  
Central Venous ◽  
Additional Risk ◽  
Current Guidelines ◽  
Coagulation Pathway

In the general population, the incidence of thromboembolic events is 117 cases/100,000 inhabitants/year, while in cancer patient incidence, it is four-fold higher, especially in patients who receive chemotherapy and who are affected by pancreatic, lung or gastric cancer. At the basis of venous thromboembolism (VTE) there is the so-called Virchow triad, but tumor cells can activate coagulation pathway by various direct and indirect mechanisms, and chemotherapy can contribute to VTE onset. For these reasons, several studies were conducted in order to assess efficacy and safety of the use of anticoagulant therapy in cancer patients, both in prophylaxis setting and in therapy setting. With this review, we aim to record principal findings and current guidelines about thromboprophylaxis in cancer patients, with particular attention to subjects with additional risk factors such as patients receiving chemotherapy or undergoing surgery, hospitalized patients for acute medical intercurrent event and patients with central venous catheters. Nonetheless we added a brief insight about acute and maintenance therapy of manifested venous thromboembolism in cancer patients.

Effect of Nurse Staffing and Antimicrobial-Impregnated Central Venous Catheters on the Risk for Bloodstream Infections in Intensive Care Units

2003 ◽  
Vol 24 (12) ◽  
pp. 916-925 ◽  
Author(s):  
Juan Alonso-Echanove ◽  
Jonathan R. Edwards ◽  
Michael J. Richards ◽  
Patrick Brennan ◽  
Richard A. Venezia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Risk ◽  
Multivariable Analysis ◽  
Nurse Staffing ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Prevention Measures ◽  
Central Venous ◽  
Central Catheters

AbstractBackground:Defining risk factors for central venous catheter (CVC)-associated bloodstream infections (BSIs) is critical to establishing prevention measures, especially for factors such as nurse staffing and antimicrobial-impregnated CVCs.Methods:We prospectively monitored CVCs, nurse staffing, and patient-related variables for CVC-associated BSIs among adults admitted to eight ICUs during 2 years.Results:A total of 240 CVC-associated BSIs (2.8%) were identified among 4,535 patients, representing 8,593 CVCs. Antimicrobial-impregnated CVCs reduced the risk for CVC-associated BSI only among patients whose CVC was used to administer total parenteral nutrition (TPN, 2.6 CVC-associated BSIs per 1,000 CVC-days vs no TPN, 7.5 CVC-associated BSIs per 1,000 CVC-days;P= .006). Among patients not receiving TPN, there was an increase in the risk of CVC-associated BSI in patients cared for by “float” nurses for more than 60% of the duration of the CVC. In multivariable analysis, risk factors for CVC-associated BSIs were the use of TPN in non-antimicrobial-impregnated CVCs (P= .0001), patient cared for by a float nurse for more than 60% of CVC-days (P= .0019), no antibiotics administered to the patient within 48 hours of insertion (P= .0001), and patient unarousable for 70% or more of the duration of the CVC (P= .0001). Peripherally inserted central catheters (PICCs) were associated with a lower risk for CVC-associated BSI (P= .0001).Conclusions:Antimicrobial-impregnated CVCs reduced the risk of CVC-associated BSI by 66% in patients receiving TPN. Limiting the use of float nurses for ICU patients with CVCs and the use of PICCs may also reduce the risk of CVC-associated BSI.

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