Autopsy findings after prolonged catheterization of the right atrium for chemotherapy in acute leukemia

Autopsies performed upon 59 patients treated for acute leukemia through venous access provided by long term right atrial catheters demonstrated a significant incidence of thrombus formation in the vena cava or right atrium. Similar thrombi were not present in 49 patients who were treated for the same disease without long term catheters. The clinical significance of these lesions, which were not usually seen with less than 150 days of catheter use, is unclear. No increase in the likelihood of other pathologic lesions, specifically of pulmonary emboli, was seen to accompany thrombus formation nor did they seem in any way contributory to the demise of the patient. No good screening test is yet available to detect these lesions ante mortem.