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Central venous thrombosis related to the silastic Hickman-Broviac catheter in an oncologic population

J F Moss1, L D Wagman, D U Riihimaki

  • 1Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California 91010.

JPEN. Journal of Parenteral and Enteral Nutrition
|July 1, 1989
PubMed

Insights

Central venous catheters like Hickman/Broviac catheters (HC/BC) can cause thrombosis (CR-CVT). However, HC/BCs remain a safe option for long-term venous access in oncology patients, with effective treatments available for CR-CVT.

Area of Science:

  • Oncology
  • Vascular Access
  • Thrombosis

Background:

  • Subcutaneously implanted, Dacron-cuffed, central venous silastic catheters, known as Hickman/Broviac catheters (HC/BC), are widely used for long-term venous access.
  • Despite their utility, HC/BCs have not eliminated the risk of catheter-related central venous thrombosis (CR-CVT).

Purpose of the Study:

  • To identify and characterize HC/BC-related CR-CVT in oncology patients.
  • To evaluate the incidence, risk factors, treatment outcomes, and long-term sequelae of CR-CVT.
  • To assess the overall safety of HC/BC placement for long-term venous access in this population.

Main Methods:

  • Retrospective analysis of 15 oncology patients with identified HC/BC-related CR-CVT.
  • Data collection included patient demographics, diagnosis, catheter characteristics, coagulation status, and treatment modalities.
  • Follow-up data on CR-CVT resolution, sequelae, and subsequent catheter placements were analyzed.

Main Results:

  • CR-CVT occurred at a median of 155 days post-placement, with no correlation to patient or catheter factors.
  • Fourteen patients received anticoagulation and/or thrombolytic therapy; one required catheter removal for resolution.
  • Median follow-up was 362 days with no long-term sequelae; 3.7% incidence of CR-CVT was observed in a 12-month period.

Conclusions:

  • HC/BC-related CR-CVT is a complication that can occur but is manageable with current therapies.
  • No significant long-term adverse effects were observed in patients treated for CR-CVT.
  • HC/BC placement is an acceptably safe and effective method for achieving long-term venous access in oncology patients.

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