Systematic review of anticoagulant treatment of catheter-related thrombosis

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Lisa Baumann Kreuziger1, Oluwatoyosi Onwuemene2, Emma Kolesar3

  • 1Blood Center of Wisconsin, 8733 Watertown Plank Road, Milwaukee, WI 53226, United States; Medical College of Wisconsin, Department of Medicine, Division of Hematology, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States.

Thrombosis Research
|September 7, 2015
PubMed

Insights

Central venous catheter-related thrombosis (CRT) treatment lacks standardization. This review found no clear evidence on optimal anticoagulation duration, highlighting the need for prospective studies on CRT management.

Area of Science:

  • Vascular Medicine
  • Hematology
  • Clinical Thrombosis

Background:

  • Central venous catheter-related thrombosis (CRT) is a significant complication in patients needing long-term intravenous access.
  • Current treatment guidelines for CRT are often based on evidence from lower extremity thrombosis, lacking specific data for upper extremity cases.
  • The optimal duration of anticoagulation for CRT remains unclear, necessitating further investigation.

Purpose of the Study:

  • To systematically review the literature on the treatment of central venous catheter-related thrombosis (CRT).
  • To evaluate the impact of anticoagulation duration on recurrent venous thrombosis, post-thrombotic syndrome, and major hemorrhage in CRT patients.
  • To identify gaps in the evidence regarding CRT management and inform future research.

Main Methods:

  • A systematic literature search was conducted across multiple databases including PubMed, Embase, Medline, CINAHL, Cochrane, and ACP Journal Club.
  • Studies focusing on CRT treated with anticoagulation were included.
  • A total of 23 studies met the inclusion criteria from an initial screening of 1648 titles and abstracts.

Main Results:

  • No randomized controlled trials were identified; all included studies were observational.
  • Anticoagulation durations in the reviewed studies ranged widely from 8 days to over 6 months.
  • Reported incidence of post-thrombotic syndrome varied significantly (0-75%), recurrent deep vein thrombosis was 7%, pulmonary embolism was 2.8%, and major hemorrhage occurred in 2.8-4.9% of patients.

Conclusions:

  • Evidence regarding the optimal duration of anticoagulation for central venous catheter-related thrombosis is limited.
  • The variability in outcomes and definitions highlights the need for standardized reporting in CRT studies.
  • Prospective research is essential to determine the most effective anticoagulation strategies for managing CRT and improving patient outcomes.

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