Incidence of ultrasound-detected asymptomatic long-term central vein catheter-related thrombosis and fibrin sheath in cancer patients

Maria Boddi, Gianluca Villa, Marco Chiostri, Francesco De Antoniis, Ilaria De Fanti, Alessandra Spinelli, Andrea Savino, Gian Franco Gensini, Cecilia Pelagatti

Research output: Contribution to journalArticle

Abstract

Background: Most central venous catheter (CVC)-related deep vein thromboses (DVT) are asymptomatic and their incidence and clinical relevance are still under debate. Data on CVC-related fibrin sheaths are scarce. We investigated the incidence of asymptomatic DVT and fibrin sheaths in cancer patients with long-term CVC implantation who underwent Doppler ultrasound surveillance at 1, 6, and 12 months after implantation. Effects of low-weight molecular heparin (LWMH) therapy on DVT and fibrin sheaths were also analyzed. Material and methods: This prospective study was performed on a large cohort (n = 400) of patients with cancer aged >18 requiring long-term CVC implantation for chemotherapy infusion. CVC was implanted by a trained qualified staff, according to standardized protocol in a specific surgery. Patients underwent ultrasound examination at 1 and 6 months after CVC implantation to detect 'early' (1 month) and 'late' (6 months) asymptomatic DVT or fibrin sheaths incidence. Sixty-nine patients underwent US examination also 12 months after CVC implantation. Results: The incidence of CVC-related thrombosis was 0.10 events per 1000 catheter days. Anticoagulation therapy with LWMH resolved 50% of DVT, but no CVC needed removing. Incidence of new onset fibrin sheaths was 0.71 events per 1000 catheter days. Fibrin sheaths resolution occurred independently of LWMH therapy. Discussion: The incidence of asymptomatic DVT in our patients with long-term CVC is very low and does not represent per se an indication for removal of functioning CVC in patients with cancer. Fibrin sheaths are frequent (13%) and never associated with CVC dysfunction. Conclusion: Asymptomatic DVT and fibrin sheaths do not represent per se an indication for removal of functioning CVC in cancer patients who need central vein access.

Original languageEnglish
Pages (from-to)472-479
Number of pages8
JournalEuropean Journal of Haematology
Volume95
Issue number5
DOIs
Publication statusPublished - Nov 1 2015

Fingerprint

Central Venous Catheters
Fibrin
Veins
Thrombosis
Catheters
Venous Thrombosis
Incidence
Neoplasms
Low Molecular Weight Heparin
Upper Extremity Deep Vein Thrombosis
Doppler Ultrasonography
Therapeutics
Prospective Studies

Keywords

  • Central venous catheters
  • Heparin
  • Neoplasms
  • Ultrasonography
  • Venous thrombosis

ASJC Scopus subject areas

  • Hematology

Cite this

Incidence of ultrasound-detected asymptomatic long-term central vein catheter-related thrombosis and fibrin sheath in cancer patients. / Boddi, Maria; Villa, Gianluca; Chiostri, Marco; De Antoniis, Francesco; De Fanti, Ilaria; Spinelli, Alessandra; Savino, Andrea; Gensini, Gian Franco; Pelagatti, Cecilia.

In: European Journal of Haematology, Vol. 95, No. 5, 01.11.2015, p. 472-479.

Research output: Contribution to journalArticle

Boddi, M, Villa, G, Chiostri, M, De Antoniis, F, De Fanti, I, Spinelli, A, Savino, A, Gensini, GF & Pelagatti, C 2015, 'Incidence of ultrasound-detected asymptomatic long-term central vein catheter-related thrombosis and fibrin sheath in cancer patients', European Journal of Haematology, vol. 95, no. 5, pp. 472-479. https://doi.org/10.1111/ejh.12519
Boddi, Maria ; Villa, Gianluca ; Chiostri, Marco ; De Antoniis, Francesco ; De Fanti, Ilaria ; Spinelli, Alessandra ; Savino, Andrea ; Gensini, Gian Franco ; Pelagatti, Cecilia. / Incidence of ultrasound-detected asymptomatic long-term central vein catheter-related thrombosis and fibrin sheath in cancer patients. In: European Journal of Haematology. 2015 ; Vol. 95, No. 5. pp. 472-479.
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abstract = "Background: Most central venous catheter (CVC)-related deep vein thromboses (DVT) are asymptomatic and their incidence and clinical relevance are still under debate. Data on CVC-related fibrin sheaths are scarce. We investigated the incidence of asymptomatic DVT and fibrin sheaths in cancer patients with long-term CVC implantation who underwent Doppler ultrasound surveillance at 1, 6, and 12 months after implantation. Effects of low-weight molecular heparin (LWMH) therapy on DVT and fibrin sheaths were also analyzed. Material and methods: This prospective study was performed on a large cohort (n = 400) of patients with cancer aged >18 requiring long-term CVC implantation for chemotherapy infusion. CVC was implanted by a trained qualified staff, according to standardized protocol in a specific surgery. Patients underwent ultrasound examination at 1 and 6 months after CVC implantation to detect 'early' (1 month) and 'late' (6 months) asymptomatic DVT or fibrin sheaths incidence. Sixty-nine patients underwent US examination also 12 months after CVC implantation. Results: The incidence of CVC-related thrombosis was 0.10 events per 1000 catheter days. Anticoagulation therapy with LWMH resolved 50{\%} of DVT, but no CVC needed removing. Incidence of new onset fibrin sheaths was 0.71 events per 1000 catheter days. Fibrin sheaths resolution occurred independently of LWMH therapy. Discussion: The incidence of asymptomatic DVT in our patients with long-term CVC is very low and does not represent per se an indication for removal of functioning CVC in patients with cancer. Fibrin sheaths are frequent (13{\%}) and never associated with CVC dysfunction. Conclusion: Asymptomatic DVT and fibrin sheaths do not represent per se an indication for removal of functioning CVC in cancer patients who need central vein access.",
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T1 - Incidence of ultrasound-detected asymptomatic long-term central vein catheter-related thrombosis and fibrin sheath in cancer patients

AU - Boddi, Maria

AU - Villa, Gianluca

AU - Chiostri, Marco

AU - De Antoniis, Francesco

AU - De Fanti, Ilaria

AU - Spinelli, Alessandra

AU - Savino, Andrea

AU - Gensini, Gian Franco

AU - Pelagatti, Cecilia

PY - 2015/11/1

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AB - Background: Most central venous catheter (CVC)-related deep vein thromboses (DVT) are asymptomatic and their incidence and clinical relevance are still under debate. Data on CVC-related fibrin sheaths are scarce. We investigated the incidence of asymptomatic DVT and fibrin sheaths in cancer patients with long-term CVC implantation who underwent Doppler ultrasound surveillance at 1, 6, and 12 months after implantation. Effects of low-weight molecular heparin (LWMH) therapy on DVT and fibrin sheaths were also analyzed. Material and methods: This prospective study was performed on a large cohort (n = 400) of patients with cancer aged >18 requiring long-term CVC implantation for chemotherapy infusion. CVC was implanted by a trained qualified staff, according to standardized protocol in a specific surgery. Patients underwent ultrasound examination at 1 and 6 months after CVC implantation to detect 'early' (1 month) and 'late' (6 months) asymptomatic DVT or fibrin sheaths incidence. Sixty-nine patients underwent US examination also 12 months after CVC implantation. Results: The incidence of CVC-related thrombosis was 0.10 events per 1000 catheter days. Anticoagulation therapy with LWMH resolved 50% of DVT, but no CVC needed removing. Incidence of new onset fibrin sheaths was 0.71 events per 1000 catheter days. Fibrin sheaths resolution occurred independently of LWMH therapy. Discussion: The incidence of asymptomatic DVT in our patients with long-term CVC is very low and does not represent per se an indication for removal of functioning CVC in patients with cancer. Fibrin sheaths are frequent (13%) and never associated with CVC dysfunction. Conclusion: Asymptomatic DVT and fibrin sheaths do not represent per se an indication for removal of functioning CVC in cancer patients who need central vein access.

KW - Central venous catheters

KW - Heparin

KW - Neoplasms

KW - Ultrasonography

KW - Venous thrombosis

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