title: Port-a-cath-related thrombosis and postthrombotic syndrome in pediatric oncology patients.
abstract: OBJECTIVE
  To investigate Port-A-Cath (PAC)-related thrombosis and postthrombotic syndrome (PTS) in children with cancer.
  
  
  METHODS
  The study population was a consecutive cohort of children diagnosed with cancer and a PAC implanted at diagnosis. Children were evaluated for the presence of PAC-related thrombosis by magnetic resonance venography and the presence of congenital prothrombotic risk factors and PTS.
  
  
  RESULTS
  A total of 114 children (median age, 6.04 years) were included. Of these children, 48 (42%) were treated for solid tumors and 66 (58%) were treated for hematopoietic tumors, including 38 for acute lymphoblastic leukemia. At the time of magnetic resonance venography, 42 children (37%) had the PAC still in place, and 72 (63%) had the PAC removed. Overall, PACs were in place for a total of 324.92 PAC-years. PAC-related thrombosis was detected in 45 children (39.5%) with a current or previous PAC. Of these, 21 (47%) had a solid tumor, 14 (31%) had acute lymphoblastic leukemia, and 10 (22%) had another hematopoietic tumor. Younger age at diagnosis, female sex, duration of PAC use, and left-side PAC placement were independently associated with an increased risk of thrombosis, whereas asparaginase therapy and the presence of inherited prothrombotic risk factors were not. Mild PTS (ie, presence of prominent collateral vessels in the skin) was present in 5.6% of the children.
  
  
  CONCLUSIONS
  PAC-related thrombosis is common in pediatric oncology patients. In some children, thrombotic complications can lead to the development of PTS.
authors.affiliation: Division of Hematology, University Children's Hospital, Zurich, Switzerland; Children's Research Center, University Children's Hospital, Zurich, Switzerland. Electronic address: manuela.albisetti@kispi.uzh.ch.
authors.forename: Manuela
authors.initials: M
authors.lastname: Albisetti
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Kellenberger
authors.forename: Eva
authors.initials: E
authors.lastname: Bergsträsser
authors.forename: Felix
authors.initials: F
authors.lastname: Niggli
authors.forename: Sabine
authors.initials: S
authors.lastname: Kroiss
authors.forename: Mattia
authors.initials: M
authors.lastname: Rizzi
authors.forename: Markus
authors.initials: M
authors.lastname: Schmugge
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D010690:Phlebography; D054070:Postthrombotic Syndrome / Q000175:diagnosis* / Q000209:etiology; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology; D062666:Vascular Access Devices / Q000009:adverse effects*
keywords: ALL; AT; Acute lymphoblastic leukemia; Antithrombin; CVC; Central venous catheter; DVT; Deep vein thrombosis; MRV; Magnetic resonance venography; PAC; PC; PS; PTS; Port-A-Cath; Postthrombotic syndrome; Protein C; Protein S; SV; SVC; Subclavian vein; Superior vena cava