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[Deep venous thrombosis caused by central venous catheter]
C Lersch1, M Paschalidis, W Theiss
1II. und I. Medizinische Kliniken, Technischen Universität, Klinikum rechts der Isar, München.
VASA. Zeitschrift Fur Gefasskrankheiten
|July 20, 1999
Summary
Central venous access catheters can cause infections and thrombosis. Using silicone catheters with tips in the lower vena cava or right atrium minimizes thrombosis risk, especially with pre-op antibiotics and 90-day heparin for high-risk cancer patients.
Area of Science:
- Vascular Surgery
- Oncology
- Infectious Diseases
Context:
- Central venous access catheters and ports are essential in oncological and other treatments.
- Infections and venous thromboses are significant complications associated with these devices.
- Thrombosis rates vary based on catheter type, material, diameter, and tip placement.
Purpose:
- To review the complications of central venous access catheters and ports.
- To identify factors influencing the frequency of catheter-related thrombosis.
- To recommend strategies for preventing and managing thrombosis in patients with central venous access devices.
Summary:
- The lowest rates of thrombotic complications are associated with single or double lumen silicone catheters (Hickman or port catheters) positioned in the lower superior vena cava or right atrium.
- For oncological patients at high risk of thrombosis, preoperative antibiotics and a minimum of 90 days of heparin post-placement are recommended.
- Thrombosis-related catheter occlusion can be managed with low-dose urokinase or streptokinase to restore function; otherwise, treatment aligns with general thrombosis management.
Impact:
- Provides evidence-based recommendations for minimizing central venous catheter complications.
- Informs clinical practice regarding the selection and management of central venous access devices.
- Aims to improve patient safety and treatment outcomes by reducing device-related morbidity.