Peripherally inserted central catheters and upper extremity deep vein thrombosis.
The purpose of the study was to determine the incidence and risk factors for venous thrombosis in patients with a peripherally inserted central catheter (PICC). A retrospective study of all upper extremity venous duplex scans was carried out in the Vascular Medicine department from year 2000 to 2002 inclusive. A chart review of positive scans was undertaken to identify possible thrombotic risk factors. Of 317 upper extremity venous duplex scans carried out, 115, or 32%, were positive for upper extremity deep vein thrombosis. Three main risk factors were identified - presence of a central line, malignancy and administration of chemotherapy. PICC were the most common central line present. Symptomatic thrombosis occurred in 7% of PICC inserted for chemotherapy compared with 1% of PICC inserted for other reasons. Ten per cent of the patients receiving chemotherapy through a PICC developed a thrombosis. The post-thrombotic syndrome was infrequent following upper extremity deep vein thrombosis. Patients receiving chemotherapy through a PICC are at increased risk of thrombosis. There may be a role for prophylactic low-dose anticoagulation in these high-risk patients.
Ong
B
B
Department of Vascular Medicine, Department of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Gibbs
H
H
Catchpole
I
I
Hetherington
R
R
Harper
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D034941:Upper Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control