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Translumbar inferior vena cava catheters
W D Haire1, R P Lieberman, G B Lund
1Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Insights
Daily aspirin significantly reduces catheter thrombosis in patients undergoing stem cell collection via translumbar inferior vena cava (IVC) catheters. This safe intervention improves apheresis procedure success rates, making it a valuable consideration for patient care.
Area of Science:
- Hematology
- Transplantation Medicine
- Vascular Access
Background:
- Translumbar inferior vena cava (IVC) catheters are essential for peripheral blood stem cell (PBSC) collection.
- Thrombotic obstruction is a frequent complication, occurring in approximately 20% of cases.
- Effective strategies to prevent catheter-related thrombosis are needed.
Purpose of the Study:
- To evaluate the efficacy of daily aspirin in reducing thrombotic obstruction of translumbar IVC catheters.
- To assess the impact of aspirin on the success rate of apheresis procedures for PBSC collection.
Main Methods:
- A prospective study involving patients undergoing PBSC collection via translumbar IVC catheters.
- Patients received aspirin 325 mg daily starting post-catheter placement until collection completion.
- Outcomes were compared to historical control data.
Main Results:
- Aspirin significantly reduced catheter thrombosis from 20% (12/60) to 3.2% (1/31) (p = 0.007).
- The incidence of thrombus-free apheresis procedures increased significantly (p = 0.024) with aspirin use.
- No adverse effects of aspirin were observed during stem cell collection.
Conclusions:
- Daily aspirin (325 mg) is a safe and effective method to prevent thrombotic obstruction in translumbar IVC catheters.
- Aspirin administration improves the success rate of apheresis procedures for PBSC collection.
- Consideration of daily aspirin is recommended for patients receiving translumbar IVC catheters for stem cell collection.
Abstract:
Translumbar inferior vena cava catheters are a safe method of providing venous access for the collection of peripheral blood stem cells for transplantation. One of the most frequent and consistent problems with these catheters is thrombotic obstruction, occurring in one-fourth of the cases. Aspirin at a dose of 325 mg daily beginning after catheter placement and continuing until completion of stem cell collection has been associated with a reduction in the frequency of catheter thrombosis from 12/60 (20%) to 1/31 (3.2%) (p = 0.007) and an increase in the number of thrombus-free apheresis procedures (p = 0.024) compared to historical controls. No adverse effects of aspirin during stem cell collection have been noted. Daily aspirin ingestion should be considered in patients undergoing peripheral stem cell collection via translumbar inferior vena cava catheters.