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Thromboprophylaxis Reduced Venous Thromboembolism in Sickle Cell Patients with Central Venous Access Devices: A

Stéphanie Forté1, Gonzalo De Luna2, Jameel Abdulrehman1

  • 1Division of Medical Oncology and Hematology, University Health Network, Toronto, ON M5G 2C4, Canada.

Journal of Clinical Medicine
|March 10, 2022
PubMed

Insights

Thromboprophylaxis may reduce venous thromboembolism (VTE) risk in sickle cell disease (SCD) patients with central venous access devices (CVADs). Hydroxyurea and certain CVAD types also impact VTE risk, warranting further study.

Area of Science:

  • Hematology
  • Vascular Medicine
  • Pharmacology

Background:

  • Sickle cell disease (SCD) creates a prothrombotic state.
  • Central venous access devices (CVADs) are frequently used in SCD patients for transfusions and chelation.
  • CVADs increase the risk of venous thromboembolism (VTE), but the benefit of thromboprophylaxis is unclear.

Purpose of the Study:

  • To investigate if thromboprophylaxis reduces VTE risk in SCD patients with CVADs.
  • To identify patient, catheter, and treatment factors associated with VTE risk in this population.

Main Methods:

  • Retrospective study of adult SCD patients with chronic CVADs (≥3 months) at two centers.
  • Recorded thromboprophylaxis use, type, and intensity.
  • Analyzed patient-, catheter-, and treatment-related VTE risk factors.

Main Results:

  • 49 patients had CVADs; 25 without and 24 with thromboprophylaxis.
  • VTE rates were higher in patients without thromboprophylaxis (RR=4.0, p=0.02).
  • Hydroxyurea use was linked to lower VTE rates (RR=20.5, p<0.001).
  • PICC lines and Vortex/Xcela Power devices had higher VTE rates than Port-a-Cath (RR=5.8, p=0.02 and RR=58.2, p<0.001, respectively).
  • Thromboprophylaxis, hydroxyurea, and CVAD type were independent VTE predictors.

Conclusions:

  • Thromboprophylaxis may offer protection against VTE in SCD patients with CVADs.
  • Hydroxyurea and specific CVAD subtypes influence VTE risk.
  • Further research is needed to confirm the role of thromboprophylaxis and hydroxyurea in VTE prevention for SCD patients with CVADs.

Keywords:
anemiacentral venous catheterssickle cellupper extremity deep vein thrombosisvascular access devicesvenous thromboembolism

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