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Port-a-cath-related thrombosis and postthrombotic syndrome in pediatric oncology patients

Manuela Albisetti1, Christian J Kellenberger, Eva Bergsträsser

  • 1Division of Hematology, University Children's Hospital, Zurich, Switzerland; Children's Research Center, University Children's Hospital, Zurich, Switzerland.

The Journal of Pediatrics
|September 3, 2013
PubMed

Insights

Port-A-Cath (PAC) thrombosis is common in pediatric cancer patients, affecting nearly 40%. Risk factors include younger age, female sex, and longer PAC use, with some cases leading to postthrombotic syndrome (PTS).

Area of Science:

  • Pediatric Oncology
  • Vascular Access Devices
  • Thrombosis Research

Background:

  • Port-A-Cath (PAC) devices are crucial for chemotherapy delivery in pediatric cancer patients.
  • Thrombosis and postthrombotic syndrome (PTS) are potential complications associated with PAC use.
  • Understanding the incidence and risk factors for PAC-related thrombosis is essential for patient management.

Purpose of the Study:

  • To determine the prevalence of Port-A-Cath (PAC)-related thrombosis in children undergoing cancer treatment.
  • To identify risk factors associated with the development of PAC-related thrombosis.
  • To assess the incidence of postthrombotic syndrome (PTS) in this pediatric cohort.

Main Methods:

  • A consecutive cohort of 114 pediatric cancer patients with PACs was evaluated.
  • Magnetic resonance venography was used to diagnose PAC-related thrombosis.
  • Congenital prothrombotic risk factors and PTS were assessed.

Main Results:

  • Nearly 40% (39.5%) of children experienced PAC-related thrombosis.
  • Younger age, female sex, longer PAC duration, and left-sided placement were linked to increased thrombosis risk.
  • Mild PTS was observed in 5.6% of patients.

Conclusions:

  • PAC-related thrombosis is a frequent complication in pediatric oncology.
  • Thrombotic events can lead to the development of PTS in some children.
  • Further research may inform strategies to mitigate PAC-related thrombotic risks.
Abstract

Keywords:
ALLATAcute lymphoblastic leukemiaAntithrombinCVCCentral venous catheterDVTDeep vein thrombosisMRVMagnetic resonance venographyPACPCPSPTSPort-A-CathPostthrombotic syndromeProtein CProtein SSVSVCSubclavian veinSuperior vena cava

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