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Thermoregulatory central venous catheter-associated thrombus - echocardiographic detection and novel approach to
Stuart Gillon1, Thoraya Ammar2, Michael Adlam1
1Department of Critical Care, King's College Hospital, Denmark Hill, London, UK.
An extensive caval thrombus was incidentally detected in a neurosurgical patient by clinician-delivered critical care echocardiography. Recent intracranial haemorrhage prevented therapeutic anticoagulation; the very proximal nature of the thrombus precluded standard deployment of an inferior vena cava filter. We describe the novel radiological technique employed to manage the thrombus, and examine whether a thermoregulatory central venous catheter inserted as part of standard neuro-critical care may have contributed to the risk and extent of the caval thrombus.
An extensive caval thrombus was incidentally detected in a neurosurgical patient by clinician-delivered critical care echocardiography. Recent intracranial haemorrhage prevented therapeutic anticoagulation; the very proximal nature of the thrombus precluded standard deployment of an inferior vena cava filter. We describe the novel radiological technique employed to manage the thrombus, and examine whether a thermoregulatory central venous catheter inserted as part of standard neuro-critical care may have contributed to the risk and extent of the caval thrombus.
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