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Risk Factors for Catheter-Related Thrombosis.

Leyla La Cava¹, Davide Giustivi², Arianna Bartoli¹

¹Internal Medicine, Ospedale Luigi Sacco, Aziende Socio Sanitarie Territoriali (ASST) Fatebenefratelli-Sacco, 20157 Milan, Italy.

Journal of Clinical Medicine

|May 27, 2026

Summary

This summary is machine-generated.

Pharmacological prophylaxis, including anticoagulant and antiplatelet therapy, significantly reduces catheter-related thrombosis (CRT) risk in patients with peripherally inserted central catheters (PICCs) and midline catheters (MCs). PICC use also lowers CRT incidence.

Keywords:

anticoagulants catheter-related thrombosis central venous catheter compression ultrasonography midline catheters peripherally inserted central catheters platelet aggregation inhibitors thromboprophylaxis

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Area of Science:

Vascular Access Devices
Thrombosis Research
Pharmacological Interventions

Background:

Catheter-related thrombosis (CRT) is a significant complication of peripherally inserted central catheters (PICCs) and midline catheters (MCs), despite adherence to insertion guidelines.
The efficacy of pharmacological prophylaxis for preventing CRT remains a subject of ongoing debate within the medical community.

Purpose of the Study:

To evaluate the incidence of CRT in patients undergoing anticoagulant therapy (prophylactic or therapeutic) and antiplatelet therapy.
To assess the protective effects of these pharmacological interventions against CRT in patients with PICCs and MCs.

Main Methods:

Retrospective study of 1431 adult patients at a tertiary care hospital (March 2021-May 2023).
Analysis of confounders including anticoagulation status, antiplatelet therapy, catheter type (PICCs vs. MCs), number of lumens, CRT risk factors, and drug infusion.
CRT diagnosis via compression ultrasonography in symptomatic patients; statistical analysis using propensity score weighting and logistic regression.

Main Results:

Peripherally inserted central catheters (PICCs) and therapeutic anticoagulant therapy demonstrated strong protective effects against CRT (OR 0.068 and 0.007, respectively).
Prophylactic anticoagulant therapy (OR 0.328) and antiplatelet therapy (OR 0.342) also showed significant protective effects.
No independent association found between CRT and catheter lumens, risk factors, or infusion of irritating drugs.

Conclusions:

Anticoagulant drugs (prophylactic and therapeutic), antiplatelet therapy, and PICC utilization significantly reduce the risk of catheter-related thrombosis.
Findings support personalized strategies for CRT prevention.
A randomized controlled trial is recommended to validate these observations.