Thrombotic complications in patients with hereditary bleeding disorders

2004 ◽  
Vol 92 (08) ◽  
pp. 298-304 ◽  
Author(s):  
Massimo Franchini
Keyword(s):  
Risk Factors ◽  
Gene Mutations ◽  
Coagulation Factor ◽  
Venous Catheter ◽  
Bleeding Tendency ◽  
Bleeding Disorders ◽  
Central Venous ◽  
Prothrombotic Risk Factors ◽  
Thrombotic Complications ◽  
Factor Concentrate

SummaryThromboses in patients with hereditary bleeding disorders are uncommon. However, in some cases, the co-existence of prothrombotic risk factors may increase the likelihood of developing thrombotic complications in such patients. This review summarizes the cases of thrombosis reported in the literature and analyzes the most important risk factors for thrombosis in patients with a congenital bleeding tendency. In particular we focus on central venous catheter (CVC)-associated thrombosis, on the thrombotic complications of coagulation factor concentrate therapy and on the presence of prothrom-botic gene mutations. Data were identified by searches of the published literature, including PubMed, references from reviews and abstracts from the most important meetings on this topic. In conclusion, there is increasing evidence that thrombotic complications in patients with hereditary bleeding disorders have a multifactorial pathogenesis, depending on exogenous (coagulation factor replacement therapy, CVC, HIV infection) and/or endogenous (prothrombotic gene mutations) risk factors.

scholarly journals Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer

Cancer ◽  
2010 ◽  
Vol 116 (17) ◽  
pp. 4197-4205 ◽  
Author(s):  
S. Revel-Vilk ◽  
J. Yacobovich ◽  
H. Tamary ◽  
G. Goldstein ◽  
S. Nemet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Children And Adolescents ◽  
Venous Catheter ◽  
Central Venous ◽  
Thrombotic Complications

scholarly journals Successful removal of a central venous catheter misplaced in the right subclavian artery using an intravascular stent: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Haruka Yoshida ◽  
Shinichiro Ikemoto ◽  
Yasuyuki Tokinaga ◽  
Kanako Ejiri ◽  
Tomoyuki Kawamata
Keyword(s):  
Central Venous Catheter ◽  
Subclavian Artery ◽  
Axillary Artery ◽  
Insertion Site ◽  
Venous Catheter ◽  
Central Venous ◽  
Thrombotic Complications ◽  
Successful Removal ◽  
Intravascular Stent ◽  
The Right

Abstract Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

scholarly journals Guide-wire replacement of a mini-midline catheter with a central venous catheter: A retrospective study on 63 cases

2020 ◽  
pp. 112972982094406
Author(s):  
Lucio Brugioni ◽  
Elisabetta Bertellini ◽  
Mirco Ravazzini ◽  
Marco Barchetti ◽  
Andrea Borsatti ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Guide Wire ◽  
Case Series ◽  
Venous Catheter ◽  
Venous Access ◽  
Late Complications ◽  
Central Catheter ◽  
Central Venous ◽  
Single Lumen ◽  
Thrombotic Complications

Background: Achieving a reliable venous access in a particular subset of patients and/or in emergency settings can be challenging and time-consuming. Furthermore, many hospitalized patients do not meet the criteria for central venous catheter positioning, unless an upgrade of the treatment is further needed. The mini-midline catheter has already showed to be reliable and safe as a stand-alone device, since it is easily and rapidly inserted and can indwell up to 1 month. Methods: In this further case series, we retrospectively evaluated data from 63 patients where a previously inserted mini-midline catheter was upgraded to a central venous catheter (the devices inserted in the arm replaced by peripherally inserted central catheter and others inserted “off-label” in the internal jugular replaced by single lumen centrally inserted central catheter), being used as introducer for the Seldinger guidewire. Results: The guidewire replacement was been made even early (after 1 day) or late (more than 10 days), usually following a need for an upgrade in treatment. No early or late complications were reported. Conclusion: According to the preliminary data we collected, this converting procedure seems to be feasible and risk-free, since neither infectious nor thrombotic complications were reported.

Risk factor identification and predictive models for central line requirements for patients on vasopressors

2021 ◽  
pp. 0310057X2110242
Author(s):  
Adrian D Haimovich ◽  
Ruoyi Jiang ◽  
Richard A Taylor ◽  
Justin B Belsky
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Single Agent ◽  
Composite Endpoint ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous

Vasopressors are ubiquitous in intensive care units. While central venous catheters are the preferred route of infusion, recent evidence suggests peripheral administration may be safe for short, single-agent courses. Here, we identify risk factors and develop a predictive model for patient central venous catheter requirement using the Medical Information Mart for Intensive Care, a single-centre dataset of patients admitted to an intensive care unit between 2008 and 2019. Using prior literature, a composite endpoint of prolonged single-agent courses (>24 hours) or multi-agent courses of any duration was used to identify likely central venous catheter requirement. From a cohort of 69,619 intensive care unit stays, there were 17,053 vasopressor courses involving one or more vasopressors that met study inclusion criteria. In total, 3807 (22.3%) vasopressor courses involved a single vasopressor for less than six hours, 7952 (46.6%) courses for less than 24 hours and 5757 (33.8%) involved multiple vasopressors of any duration. Of these, 3047 (80.0%) less than six-hour and 6423 (80.8%) less than 24-hour single vasopressor courses used a central venous catheter. Logistic regression models identified associations between the composite endpoint and intubation (odds ratio (OR) 2.36, 95% confidence intervals (CI) 2.16 to 2.58), cardiac diagnosis (OR 0.72, CI 0.65 to 0.80), renal impairment (OR 1.61, CI 1.50 to 1.74), older age (OR 1.002, Cl 1.000 to 1.005) and vital signs in the hour before initiation (heart rate, OR 1.006, CI 1.003 to 1.009; oxygen saturation, OR 0.996, CI 0.993 to 0.999). A logistic regression model predicting the composite endpoint had an area under the receiver operating characteristic curve (standard deviation) of 0.747 (0.013) and an accuracy of 0.691 (0.012). This retrospective study reveals a high prevalence of short vasopressor courses in intensive care unit settings, a majority of which were administered using central venous catheters. We identify several important risk factors that may help guide clinicians deciding between peripheral and central venous catheter administration, and present a predictive model that may inform future prospective trials.

Unfractionated Heparin (UFH) For Prevention of Central Venous Catheter Thrombotic Complications in Children: A systematic review and meta-analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Marwa W Nasef ◽  
Maha M El-gaffary ◽  
Mervet G Mansour ◽  
Esraa S Abd El Aty
Keyword(s):  
Central Venous Catheter ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Meta Analysis ◽  
Venous Catheter ◽  
Controlled Trials ◽  
Central Venous ◽  
Thrombotic Occlusion ◽  
Thrombotic Complications

Abstract Objective To determine the efficacy of unfractionated heparin in reducing central venous catheter-related deep venous thrombosis and/or catheter thrombotic occlusion in children by systematically searching the literature and conducting a meta-analysis study. Methods Four electronic databases (PubMed, Google Scholar, Elsevier’s thrombosis journal, and the Cochrane Central Register for Controlled Trials) were searched for journal peer-reviewed articles published in the period from Jan 2000 to Dec 2018. The search criteria included observational studies, and randomized controlled trials on patients aged 0–18 years with central venous catheters (CVC), which compare between the effect of UFH (flushes, lock solutions, continuous infusion, and heparin bonded catheter) and no prophylaxis (Normal saline flush or no treatment) for the prevention of CVC thrombotic complications (CVC-related deep venous thrombosis (DVT) and/or catheter thrombotic occlusion). Two authors independently reviewed and identified the eligible studies, which were assessed for study methodology including bias, and extraction of unadjusted data whenever available. To pool data from eligible studies, the meta-analysis was performed on RevMan version 5.3. Odds ratios were generated with the corresponding 95% CI through the random-effect model. Results Of the 413 articles identified, only eight studies were eligible with 1380 patients. Our results revealed that UFH was significantly superior on control group in reducing thrombotic occlusion and/or CVC-related DVT (odds ratio 0.39, 95% CI: 0.19:0.8) (p 0.01). Conclusion The published data support the hypothesis that using UFH as a thromboprophylaxis may significantly reduce catheter thrombotic complication in pediatric patients with CVC.

scholarly journals Venous anomalies as potentially lethal risk factors during ordinary catheterization

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Savino Occhionorelli ◽  
Sergio Gianesini ◽  
Lorenzo Marinelli ◽  
Marianna Daniele ◽  
Sara Chierici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Central Venous Catheter ◽  
Literature Review ◽  
Venous Catheter ◽  
Clinical Implications ◽  
Venous Malformations ◽  
Central Venous ◽  
Venous Anomalies ◽  
Technology Advancement

Venous malformations are rare but possible findings too, constituting a further risk factor for central venous catheter procedures. Herein we describe a case of death because of an innominate vein perforation by a catheter that incidentally was tucked into a sacciform malformation. Even if the technology advancement is constantly offering us new investigation tools, up to now diagnostic options are limited in the detection of those malformations that could potentially lead to dramatic complications as the described one. The present work raises the awareness about rare venous anomalies and their potential clinical implications. A proper literature review and diagnostic implementation proposal are reported.

scholarly journals Risk Factors of Central Venous Catheter Leakage in Neonatal Intensive Care Unit

Perinatology ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 60 ◽  
Author(s):  
Young Duck Kim ◽  
Na Mi Lee ◽  
Su Yeong Kim ◽  
Dae Yong Yi ◽  
Sin Weon Yun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Central Venous

scholarly journals THE CONTRIBUTION OF CARRIER THE ALLELIC VARIANT G1691A OF THE GENE V OF COAGULATION FACTOR TO THE DEVELOPMENT OF THROMBOTIC COMPLICATIONS DEPENDING ON THE PRESENCE OF CARDIOVASCULAR RISK FACTORS IN INDIVIDUALS WITH SECONDARY LEUKOCYTOSIS, THROMBOCYTOSIS A

2019 ◽  
Vol 4 (9-10) ◽  
pp. 61-67
Author(s):  
O. Y. Mishcheniuk ◽  
O. M. Kostiukevych ◽  
L. K. Benkovska ◽  
A. N. Kravchenko
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Confidence Interval ◽  
Peripheral Blood ◽  
Coagulation Factor ◽  
Hereditary Thrombophilia ◽  
Reactive Changes ◽  
Thrombotic Complications ◽  
Thrombogenic Potential ◽  
Type 3

Introduction. In addition to the "Classical" Risk Factors (RF) for Arterial and Venous Thrombosis, some authors, as triggers for the development of the latter, refer to reactive changes in Peripheral Blood (PB) counts and markers of Hereditary Thrombophilia. The results of most studies indicate that the "Classical" Risk Factors (RF) for Vascular Thrombotic Episodes are strong triggers of their development, the presence of which eliminates the Pro-thrombogenic potential of carrier of the Hereditary Thrombophilia and reactive changes in Peripheral Blood (PB) (RChPB). However, to date, there is no data regarding the assessment of contribution of the Leiden Mutation in the cohort with both reactive changes in Peripheral Blood (PB) and Risk Factors (RF) for Thrombotic Complications (ThC). Results. In patients with reactive changes in the Peripheral Blood (PB), the Leiden Mutation occurs in 5,92% of cases (9 carriers). In individuals with Thrombotic Complications (ThC), the Allele G1691A of the Proaccelerin Gene is determined more often than in a cohort without them (5 out of 31 vs 4 out of 121; p=0,030). In the general cohort of individuals with reactive changes in Peripheral Blood (PB), carriage of the Leiden Mutation increased the risk of Thrombotic Complications (ThC) by 3,05 times (Relative Risk (RR) = 3,05; 95% Confidence Interval (CI) = 1,54-6,03). In patients without Risk Factors (RF) and people under 60 years of age, Thrombosis occurred more often with the Nucleotide Variant of Allele G1691A of the Gene V of Coagulation Factor than with the Allele of wild-type (3 out of 6 vs 4 out of 75; p=0,007 and 4 out of 6 vs 8 out of 107; p=0,010, respectively). The probability of developing of Thrombosis with carriage the Allele G1691A of the Proaccelerin Gene in patients with Thrombotic Complications (ThC) without Risk Factors (RF) and in younger patients was 10,57 (95% Confidence Interval (CI) = 2,60-42,87) and 16,83 times (95% Confidence Interval =3,43-82,41), respectively. The risk of Thrombotic events in people without Risk Factors (RF) younger than 60 years is 16,75 times (Relative Risk (RR) = 16,75; 95% Confidence Interval (CI) = 3,44-81,50). However, the frequency and risk of Thrombosis did not increase in individuals with Risk Factors (RF), in patients over 60 years of age or in a cohort with Risk Factors over 60 years of age. Conclusion. Carriage the Allele G1691A of the Gene V of Coagulation Factor in patients with reactive Thrombocytosis, Leukocytosis and Secondary Polycythemia increases the risk of Thrombosis primarily due to patients without Risk Factors (RF) younger than 60 years.

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