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Risk factors determining central venous access device-associated deep vein thrombosis resolution in children: a

Miguel García-Boyano1, José Manuel Caballero-Caballero2, Marta García Fernández de Villalta2

  • 1La Paz University Hospital, Madrid, Spain. miguelgarciaboyano@gmail.com.

European Journal of Pediatrics
|February 8, 2021
PubMed

Insights

Pediatric deep vein thrombosis (DVT) linked to central venous access devices (CVADs) is less likely to resolve if it is occlusive, in the upper body, or shows early collateral circulation. Fewer prothrombotic risk factors also correlate with poorer DVT resolution in children.

Area of Science:

  • Pediatric Thrombosis and Hemostasis
  • Vascular Medicine
  • Medical Device Complications

Background:

  • Risk factors for central venous access device (CVAD)-associated deep vein thrombosis (DVT) resolution are understudied in pediatric populations.
  • Current guidelines recommend a maximum of 3 months of anticoagulation for provoked DVT if the provoking factor is resolved.

Purpose of the Study:

  • To investigate risk factors associated with the lack of thrombus resolution within the first 6 months in children with CVAD-associated DVT.
  • To inform decisions regarding the initiation and continuation of anticoagulant therapy based on predicted thrombus resolution.

Main Methods:

  • Retrospective study of 85 pediatric patients diagnosed with CVAD-associated DVT.
  • Multivariate analysis to identify variables associated with no thrombus resolution at 6 months post-diagnosis.

Main Results:

  • Thrombus resolution occurred in 62 children after a median of 50 days.
  • Factors significantly associated with no resolution included occlusive thrombi (OR 12.50), upper extremity/head/neck vein location (OR 17.70), early collateral circulation (OR 33.55), and fewer prothrombotic risk factors (OR 6.20).

Conclusions:

  • CVAD-associated DVT resolution in children is significantly lower in cases of occlusive thrombi, upper body vein location, early collateral circulation, and fewer initial prothrombotic risk factors.
  • Identifying these risk factors can aid in tailoring anticoagulant treatment duration and intensity for pediatric patients.

Keywords:
ChildrenLow-molecular-weight heparinRisk factorsThrombus resolutionVenous thrombosis

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