Central Venous Catheter Thrombosis in Cancer: A Multi-Centre Retrospective Study Investigating Risk Factors and Contemporary Trends in Management

Objectives: Central venous access is needed to facilitate chemotherapy for many cancer patients. Central venous catheter-related thrombosis (CVCT) is a major complication that can cause significant morbidity and mortality. We sought to explore the rate of CVCT in a general cancer population in Australia and to identify factors associated with increased risk of thrombosis. Design: This is a multi-centre retrospective cohort study. Setting and participants: We analysed key patient, treatment, and cancer-related factors for 317 patients with cancer and central venous catheters inserted for systemic therapy. Main outcome measures: Symptomatic CVCT confirmed with imaging and management of patients with CVCT. Results: A total of 402 cases of central line insertion were analysed. Central venous catheter-related thrombosis occurred in 24 patients (6.0%). Having a peripherally inserted central catheter (PICC; HR = 3.78, 95% CI = 1.28-11.19, P = .02) compared with an implantable port and a body mass index of ⩾25.0 kg/m2 (HR = 3.60, 95% CI = 1.31-9.85, P = .01) were independently associated with increased risk of thrombosis. Central venous catheter-related thrombosis was managed mostly with removal of the catheter (19 of 24 cases) and anticoagulation, including direct-acting oral anticoagulants in 5 patients. Conclusions: This work explored rates of CVCT in a general cancer population, observing increased rates in those with PICCs or increased body mass index.

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Faculty Opinions recommendation of Central venous catheter repair is associated with an increased risk of bacteremia and central line-associated bloodstream infection in pediatric patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14264133.15777271 ◽

2012 ◽

Author(s):

Theo Zaoutis

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infection ◽

Pediatric Patients ◽

Venous Catheter ◽

Central Line ◽

Central Venous ◽

Increased Risk

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Central venous catheter related thrombosis in children: Analysis of the Canadian Registry of Venous Thromboembolic Complications

The Journal of Pediatrics ◽

10.1016/s0022-3476(98)70149-0 ◽

1998 ◽

Vol 133 (6) ◽

pp. 770-776 ◽

Cited By ~ 286

Author(s):

M.Patricia Massicotte ◽

David Dix ◽

Paul Monagle ◽

Margaret Adams ◽

Maureen Andrew

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Thromboembolic Complications ◽

Central Venous ◽

Venous Thromboembolic ◽

Catheter Related Thrombosis

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Central Venous Catheter induced Atrial Fibrillation-A Case Report

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v39i3.54168 ◽

2021 ◽

Vol 39 (3) ◽

pp. 200-204

Author(s):

Masud Ahmed ◽

Azizun Nessa ◽

Md Al Amin Salek

Keyword(s):

Atrial Fibrillation ◽

Central Venous Catheter ◽

Central Venous Access ◽

Venous Catheter ◽

Venous Access ◽

Cardiac Complications ◽

Haemodynamic Instability ◽

Central Venous ◽

Common Procedure ◽

Dc Cardioversion

Though a common procedure, central venous access is related to morbidity and mortality of patients. Common cardiac complications caused by central venous catheters include premature atrial and ventricular contractions. But development of atrial fibrillation with haemodynamic instability is quite rare. We are reporting a patient who developed atrial fibrillation with hypotension while inserting central venous catheter through right subclavian vein by landmark technique. Patient was managed with DC cardioversion. Careful insertion of central venous catheter & prompt management of its complication is crucial to avoid catastrophe. J Bangladesh Coll Phys Surg 2021; 39(3): 200-204

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Early prophylaxis of central venous catheter-related thrombosis using 1% chlorhexidine gluconate and chlorhexidine-gel-impregnated dressings: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-020-72709-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Tomoko Yamashita ◽

Ayako Takamori ◽

Akira Nakagawachi ◽

Yoshinori Tanigawa ◽

Yohei Hamada ◽

...

Keyword(s):

Cohort Study ◽

Central Venous Catheter ◽

Retrospective Cohort Study ◽

Critically Ill Patients ◽

Retrospective Cohort ◽

Venous Catheter ◽

Chlorhexidine Gluconate ◽

Central Venous ◽

Chlorhexidine Gel ◽

Catheter Related Thrombosis

Abstract To determine the prophylactic effect of using combined 1% alcoholic chlorhexidine gluconate and chlorhexidine gel-impregnated dressings (CGCD) on catheter-related thrombosis (CRT) in critically ill patients. This retrospective cohort study was performed in an intensive care unit from November 2009 to August 2014. The CRT incidence diagnosed with ultrasound examination was compared between patients applying CGCD and combined 10% aqueous povidone-iodine and standard transparent dressings (PITD) after central venous catheter insertion into the internal jugular vein for ≥ 48 h. CRT was stratified into early (within 7 days) and late (days 8–14) thromboses. Multivariate analyses using logistic regression models clarified the relationships between early- and late-CRT risks and skin antiseptic and catheter site dressing combinations. CRT occurred in 74 of 134 patients (55%), including 52 with early CRT and 22 with late CRT. Patients receiving CGCD had a significantly lower incidence of early CRT than those receiving PITD (odds ratio = 0.18; 95% confidence interval = 0.07–0.45, p < .001). No significant association was evident between using CGCD and late CRT (p = .514). Compared to PITD, CGCD reduced the CRT risk over 7 days in critically ill patients. UMIN Clinical Trials Registry: UMIN000037492.

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Linezolid lock prophylaxis of central venous catheter infection

Journal of Medical Microbiology ◽

10.1099/jmm.0.47665-0 ◽

2008 ◽

Vol 57 (4) ◽

pp. 534-535 ◽

Cited By ~ 4

Author(s):

Jérôme Patrick Fennell ◽

Martin O'Donohoe ◽

Martin Cormican ◽

Maureen Lynch

Keyword(s):

Central Venous Catheter ◽

Hospital Admissions ◽

Blood Stream Infection ◽

Central Venous Access ◽

Venous Catheter ◽

Venous Access ◽

Blood Stream ◽

Central Venous ◽

Central Venous Catheter Infection ◽

The Impact

Central venous catheter (CVC)-related infections are a major problem for patients requiring long-term venous access and may result in frequent hospital admissions and difficulties in maintaining central venous access. CVC-related blood stream infections are associated with increased duration of inpatient stay and cost approximately \#8364;13 585 per patient [Blot, S. I., Depuydt, P., Annemans, L., Benoit, D., Hoste, E., De Waele, J. J., Decruyenaere, J., Vogelaers, D., Colardyn, F. & Vandewoude, K. H. (2005). Clin Infect Dis 41, 1591–1598]. Antimicrobial lock therapy may prevent CVC-related blood stream infection, preserve central venous access and reduce hospital admissions. In this paper, the impact of linezolid lock prophylaxis in a patient with short bowel syndrome is described.

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