Direct Oral Anticoagulants for Treating Fibrin Sheath-induced Central Venous Port System Dysfunction.

Area of Science:

• Vascular Access Devices
• Pharmacology
• Interventional Radiology

Background:

• Fibrin sheath formation is a common complication of central venous port systems.
• This complication can lead to port dysfunction, impacting treatment delivery.
• Current management strategies for fibrin sheath may have limitations.

Purpose of the Study:

• To evaluate the safety and efficacy of direct oral anticoagulant (DOAC) therapy.
• To assess DOACs for managing fibrin sheath-induced central venous port system dysfunction.

Main Methods:

• Retrospective review of nine patients treated with edoxaban for fibrin sheath-induced port dysfunction.
• Assessed clinical effectiveness, flow confirmation, port function, and adverse events (CTCAE).

Main Results:

• Complete fibrin sheath resolution occurred in 100% of patients within a mean of 29 days.
• Central venous port function was restored in 88.9% of cases.
• No grade 3 or higher adverse events were observed; one patient had mild epistaxis.

Conclusions:

• Direct oral anticoagulant therapy is a potentially effective and safe option.
• DOACs can successfully manage fibrin sheath-induced central venous port dysfunction.
• This approach offers a promising alternative for restoring port function.