Central venous thrombosis related to the silastic Hickman-Broviac catheter in an oncologic population.
The use of subcutaneously implanted, Dacron cuffed, central venous silastic catheters (Hickman/Broviac catheter [HC/BC]) has not eliminated catheter related-central venous thrombosis (CR-CVT). HC/BC related CR-CVT was identified and followed in 15 oncology patients. Median time period to CR-CVT was 155 days (range 15-638). No correlation was established to patient age, sex, diagnosis, coagulation status, use, longevity, technique, or site of placement. Fourteen patients were treated with anticoagulation and/or thrombolytic therapy. Of seven patients treated with HC/BC in situ, one required HC/BC removal to achieve CR-CVT resolution. Median follow-up post-CR-CVT was 362 days (range 34-1622). No patient suffered untoward long-term sequelae. Nine patients had 11 catheters placed following resolution of CR-CVT. None had repeat thrombosis. CR-CVT incidence in a single 12-month period was 3.7% (7/190). The placement of HC/BC in an oncology population is an acceptably safe method for long-term venous access.
Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California 91010.
J F
JF
Moss
L D
LD
Wagman
D U
DU
Riihimaki
J J
JJ
Terz
D000328:Adult; D000367:Age Factors; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D012449:Safety; D012737:Sex Factors; D012826:Silicone Elastomers; D013927:Thrombosis / Q000209:etiology*
D012826:Silicone Elastomers