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Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
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Updated: Jul 20, 2026

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

Peripherally inserted central catheters and upper extremity deep vein thrombosis.

B Ong1, H Gibbs, I Catchpole

  • 1Department of Vascular Medicine, Department of Diagnostic Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Australasian Radiology
|September 20, 2006
PubMed
Summary

This study looked at the risk of blood clots in the arm veins of patients with a type of central line called a PICC. Researchers reviewed medical records from 2000 to 2002 and found that 32% of patients with PICCs had clots. Three main risk factors were identified: having a central line, having cancer, and receiving chemotherapy. Patients getting chemotherapy through a PICC had a 10% chance of developing a clot. Only 1% of patients with PICCs for other reasons had clots. The study also found that long-term complications from clots were rare. The authors suggest that some high-risk patients might benefit from low-dose blood thinners to prevent clots.

Keywords:
central line complicationschemotherapy and blood clotsupper arm vein thrombosisvascular medicine research

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Area of Science:

  • Vascular medicine
  • Clinical hematology
  • Infection control

Background:

Upper extremity deep vein thrombosis is a known complication in patients with central venous access. Prior research has shown that central lines contribute to this risk. However, the exact incidence and contributing factors remain unclear. No prior work had resolved the specific role of peripherally inserted central catheters in this context. Some studies suggest a link between malignancy and thrombosis, but evidence is inconsistent. Chemotherapy use has also been associated with increased clotting risk. The mechanisms behind this association are not fully understood. This gap motivated a detailed analysis of clinical records to clarify risk profiles. Understanding these factors may improve patient management strategies.

Purpose Of The Study:

The study aimed to evaluate the frequency of upper extremity deep vein thrombosis in patients with peripherally inserted central catheters. It focused on identifying specific risk factors linked to this condition. Researchers reviewed clinical records from a vascular medicine department. They examined venous duplex scan results between 2000 and 2002. The goal was to determine which patient characteristics correlated with thrombosis. Chemotherapy use and malignancy were considered as potential contributors. The study also compared outcomes for different catheter purposes. This approach allowed for a focused analysis of high-risk scenarios.

Main Methods:

A retrospective chart review was conducted in a vascular medicine department. Venous duplex scans from 2000 to 2002 were analyzed for thrombosis. Researchers identified 317 upper extremity scans for evaluation. Of these, 115 showed evidence of deep vein thrombosis. Patient records were reviewed to extract relevant clinical data. Central line presence, malignancy, and chemotherapy were recorded. Symptomatic versus asymptomatic cases were differentiated. The analysis compared thrombosis rates based on catheter purpose.

Main Results:

Of the 317 scans, 115 showed upper extremity deep vein thrombosis. This corresponds to a 32% incidence rate in the study population. Three main risk factors were identified: central lines, malignancy, and chemotherapy. Peripherally inserted central catheters were the most common central line type. Patients receiving chemotherapy through PICCs had a 10% thrombosis rate. Symptomatic cases occurred in 7% of chemotherapy-related PICC placements. Only 1% of non-chemotherapy PICCs led to symptomatic thrombosis. Post-thrombotic syndrome was rare in the affected patients.

Conclusions:

Patients with peripherally inserted central catheters face a 32% risk of upper extremity deep vein thrombosis. Chemotherapy administration through PICCs increases this risk to 10%. Malignancy and central line presence are significant contributing factors. The study suggests a possible benefit for low-dose anticoagulation in high-risk cases. Symptomatic thrombosis was more common in chemotherapy-related PICC use. Post-thrombotic syndrome was not a frequent complication in this cohort. These findings highlight the need for targeted monitoring strategies. The authors propose further investigation into prophylactic interventions.

The study found a 32% incidence of upper extremity deep vein thrombosis in patients with PICCs.

Peripherally inserted central catheters were the most common central line linked to thrombosis.

Patients receiving chemotherapy through PICCs had a 10% thrombosis rate, compared to 1% for other uses.

Malignancy was one of three main risk factors identified alongside central lines and chemotherapy.

The post-thrombotic syndrome was infrequent in patients with upper extremity deep vein thrombosis.

The authors propose prophylactic low-dose anticoagulation for patients at high risk of thrombosis.