[Venous thrombosis from central venous catheterization in oncology].
OBJECTIVE
The aim of this review article is to assess the epidemiology, diagnosis and treatment of deep venous thrombosis of the upper limbs which are becoming more common with the use of central catheterizations in oncology.


METHODS
The incidence is differently estimated. The catheterization is the main risk factor which is added to the proper patient's risk factors in a highly thrombogenic context (cancer, chemotherapy, infection,...). The outcome can be limited to the catheter (thrombotic) dysfunction or can progress towards vein thrombosis, pulmonary embolism, most often asymptomatic or to a superior vena cava syndrome. Ultrasounds and CT scan have an important role although their efficacy have not been demonstrated yet.


METHODS
Prophylactic anticoagulation with unfractionated heparin, low molecular weight heparin or oral anticoagulant seems to be effective. Low dose thrombolysis by bolus of urokinase or tissue plasminogen activator allows restoring the patency of the catheter in 70 to 90% cases of thrombotic dysfunction. The modalities of treatment of the vein thrombosis are much discussed.
Service de Médecine vasculaire, CHU Rangueil, 1, avenue Jean Poulhès, F 31403 Toulouse.
D
D
Gratadou
A
A
Elias
M
M
Elias
H
H
Boccalon
D000925:Anticoagulants / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants; D000970:Antineoplastic Agents; D005343:Fibrinolytic Agents