Related Experiment Video
Updated: Feb 28, 2026
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
Increased rate of venous thrombosis may be associated with inpatient dihydroergotamine treatment
Amy R Tso1, Irene R Patniyot2, Amy A Gelfand2
1From the Headache Group (A.R.T., I.R.P., A.A.G., P.J.G.), Department of Neurology, University of California, San Francisco; Headache Group (A.R.T., P.J.G.), Basic and Clinical Neuroscience, King's College London; and NIHR, Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK (A.R.T., P.J.G.). amy.tso@kcl.ac.uk.
Insights
Intravenous dihydroergotamine may increase the risk of catheter-associated venous thrombosis. Patients receiving this treatment require careful monitoring for deep vein thrombosis (DVT) and pulmonary embolism (PE).
Area of Science:
- Medical research
- Pharmacology
- Vascular medicine
Background:
- Catheter-associated venous thrombosis is a significant complication.
- The safety of intravenous dihydroergotamine in this context requires investigation.
Purpose of the Study:
- To compare the incidence of catheter-associated venous thrombosis in patients receiving IV dihydroergotamine versus lidocaine.
Main Methods:
- Retrospective review of admissions at UCSF Headache Center (2008-2014).
- Data collected included patient demographics, treatment details, and thrombotic events (SVT, DVT, PE).
- Analysis focused on patients with peripherally inserted central catheters (PICCs) or midline catheters.
Main Results:
- 19 of 263 (7.2%) patients receiving IV dihydroergotamine developed venous thrombosis or pulmonary embolism.
- None of the 52 patients receiving IV lidocaine experienced thrombotic events (p=0.05).
- Age, sex, and treatment duration were not significant predictors of thrombosis.
Conclusions:
- IV dihydroergotamine may be associated with an increased risk of catheter-associated venous thrombosis.
- Vigilance and a low threshold for diagnostic ultrasound are recommended for patients on this treatment.
- Anticoagulation therapy was frequently necessary for identified thrombotic events.
Objective:
To review whether the incidence of catheter-associated venous thromboses was higher in patients receiving IV dihydroergotamine compared to lidocaine.
Methods:
We retrospectively reviewed all admissions at the University of California, San Francisco Headache Center from February 25, 2008, through October 31, 2014, for age, sex, diagnosis, aura, treatment dose, type of IV line used, days with line, superficial (SVT) or deep venous thrombosis (DVT), and pulmonary embolism (PE).
Results:
A peripherally inserted central catheter (PICC) or midline catheter was placed in 315 of 589 (53%) admissions. Mean age was 38 years with a range of 6 to 79 years; 121 patients (21%) were ≤18 years old. Seventy-four percent (433 of 589) of patients were female. Of 263 dihydroergotamine admissions using a PICC or midline catheter, 19 (7.2%) had either an SVT or DVT or a PE; 2 patients were diagnosed with both DVT and PE. Of 52 lidocaine admissions using a PICC or midline catheter, none had a thrombotic event (p = 0.05, Fisher exact test). Age, sex, aura, total dihydroergotamine dose, and number of days with line were not significant predictors of venous thrombosis.
Conclusions:
IV dihydroergotamine treatment may be associated with an increased risk of catheter-associated venous thrombosis. A low threshold for diagnostic ultrasound investigation is appropriate because anticoagulation therapy was frequently required.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:30Venous Thrombosis IV: Nursing Management
01:30Venous Thrombosis I: Introduction
01:27Pulmonary Embolism III: Nursing Management
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:24Hemodialysis II: Procedure and Complications