Related Experiment Videos
Catheter-related thrombosis in children with cancer
D W Glaser1, D Medeiros, N Rollins
1Department of Pediatrics and Radiology, The University of Texas Southwestern Medical Center at Dallas Dallas, Texas 75235-9063, USA.
Insights
Fifty percent of pediatric cancer patients with central venous catheters experienced deep vein thrombosis. This study highlights the prevalence of asymptomatic thrombosis in children with cancer, emphasizing the need for further research into risk factors and prevention strategies.
Area of Science:
- Pediatric Oncology
- Vascular Medicine
- Thrombosis Research
Background:
- Asymptomatic catheter-related thrombosis in pediatric cancer patients with central venous catheters remains unquantified.
- Implantable central venous catheters (ports) are common in children undergoing cancer treatment.
Purpose of the Study:
- To determine the prevalence of asymptomatic catheter-related thrombosis of the upper venous system in children with cancer.
- To evaluate cancer patients with implantable central venous catheters (ports) for this complication.
Main Methods:
- A study involving children with cancer undergoing port removal.
- Vessel patency assessed via contrast venography.
- Physical examination for thrombosis stigmata and retrospective review of catheter-related issues.
Main Results:
- Twenty-four children (median age 9 years) with various cancers were evaluated.
- Venography revealed abnormalities in 50% of patients (12 of 24).
- Clinically occult central venous occlusion was found in 9 of 21 patients.
Conclusions:
- Deep venous thrombosis was present in 50% of children with cancer who had implantable ports removed.
- Further research is needed to identify inherited/acquired risk factors for thrombosis.
- Strategies for preventing and treating catheter-related thrombosis in this population require assessment.
Objective:
The prevalence of asymptomatic catheter-related thrombosis of the upper venous system in children with cancer has not been determined. We evaluated patients with cancer and implantable central venous catheters (ports) for this complication.
Study Design:
Children with cancer undergoing port removal were eligible for this study. Vessel patency was evaluated by contrast venography. We examined each child for physical stigmata of thrombosis and retrospectively assessed catheter-related mechanical difficulties and infections.
Results:
Thirty-one ports had been placed in 24 children (aged 20 months to 18 years; median age, 9 years) with diagnoses of leukemia/lymphoma (n = 10), solid tumor (n = 12), and histiocytosis (n = 2). Venography showed abnormalities in 12 of the 24 patients. Physical examination revealed dilated superficial veins on the chest in 3 patients. Venograms showed abnormalities in all 3 children with prominent superficial thoracic veins. Nine of the 21 other patients had clinically occult central venous occlusion.
Conclusion:
Fifty percent (95% CI, 30% to 70%) of children who had implantable ports removed during or after treatment of cancer exhibited deep venous thrombosis at the site of catheter placement. Future studies should determine the contribution of inherited and other acquired risk factors for thrombosis and assess measures to prevent and/or treat catheter-related thrombosis in this population.