Rivaroxaban Prophylaxis in Peripherally Inserted Central Catheter-Related Thrombosis in Breast Cancer Patients

To evaluate the efficacy and safety of rivaroxaban in preventing catheter-related thrombosis (CRT) in breast cancer patients undergoing chemotherapy with peripherally inserted central catheters (PICC).

A prospective cohort study enrolled breast cancer patients who underwent PICC placement for chemotherapy at the San Huan Cancer Hospital from November 2021 to August 2023. The treatment group received 10 mg of oral rivaroxaban daily for 2 months along with routine grip strength training, while the control group received grip strength training only. CRT occurrence was confirmed by vascular ultrasound, and group comparisons were made using the χ² test, with logistic regression analyzing CRT risk factors.

Of 314 patients, 181 received treatment and 133 were in the control group. The treatment group had a significantly lower incidence of CRT (2.2%, 4/181) compared to the control group (12.0%, 16/133) (p <0.001). Univariate analysis showed a higher risk of CRT in patients in the non-prophylaxis group (p = 0.002), patients aged ≥50 years (p = 0.014), and those with prior endocrine therapy (p = 0.030). Multivariate analysis identified rivaroxaban prophylaxis (p = 0.009) and age (p = 0.026) as independent risk factors for thrombosis. The use of rivaroxaban for prophylactic anticoagulation was safe. All CRT-diagnosed patients completed their antitumor therapy without new thrombosis or pulmonary embolism.

Two months of rivaroxaban prophylaxis effectively and safely reduce CRT incidence in breast cancer patients with PICC.