A scanning electron microscopic study on thrombogenicity of intraarterial catheters for chemotherapeutic treatment in head and neck cancer.
BACKGROUND
The purpose of this study was to assess the impact of standard anticoagulation and intermittent catheter irrigation on clot formation on intraarterial chemotherapeutical catheters.


METHODS
Sixteen nonheparinized catheters were placed in the carotid vessels of 10 patients. Ten catheters were perfused with chemotherapeutic drugs; six catheters were not perfused. Patients received LMWH anticoagulation; catheters were irrigated with boluses of heparinized saline daily. Catheters were retrieved for SEM evaluation after a mean intravessel placement interval of 21 days.


RESULTS
All samples demonstrated accumulation of thrombotic debris on luminal sides and outsides of catheters. Obliteration was seen in three samples. Detachment of thrombus fragments was present in several specimens. No significant dependence of clot formation on placement interval and chemotherapeutic perfusion was calculated.


CONCLUSIONS
Standard anticoagulation was ineffective in clot prevention. Heparinized catheters might potentially reduce the risk of clot formation. A delivery system should be engaged for continuous irrigation of catheters with heparinized saline.
University Hospital of Cranio-Maxillofacial and Oral Surgery, Medical School, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. doris.moser@akh-wien.ac.at
Doris
D
Moser
Michael
M
Rasse
Christian
C
Schopper
Georgios
G
Lagogiannis
Michael
M
Frass
Rolf
R
Ewers
Alan D
AD
Kaye
Roland
R
Hofbauer
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D007507:Therapeutic Irrigation; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D000970:Antineoplastic Agents; D006495:Heparin, Low-Molecular-Weight