Central line thrombosis in patients with cancer.
Central venous catheters are used frequently to care for patients with cancer and often serve as long-term venous access. Catheter-related central venous thrombosis is a serious and common complication in these patients. The incidence of this event ranges from 2 to 40%. Potential risk factors are catheter position, size of the catheter, and perhaps site of insertion. The diagnosis of catheter-associated deep venous thrombosis may be difficult. Doppler ultrasound has a lower accuracy in this setting than it does in symptomatic lower extremity venous thrombosis. No clinical management studies have validated the practice of withholding anticoagulant therapy in patients with a negative Doppler ultrasound. The practice of prophylaxis with low-dose warfarin or low-molecular-weight heparin has been recommended, although results from recent studies have called this into question. Larger, prospective, randomized trials with a uniform population of patients or stratification of risk factors will be essential to address this issue further.
Bona
Robert D
RD
University of Connecticut Health Center, Farmington, CT 06030-1315, USA. bona@up.uchc.edu
D000925:Anticoagulants / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*
D000925:Anticoagulants; D000970:Antineoplastic Agents