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Anticoagulation without catheter removal in children with catheter-related central vein thrombosis

B D Kenney1, M David, A L Bensoussan

  • 1Department of Hematology, Hôpital Sainte-Justine, Montreal, Quebec, Canada.

Journal of Pediatric Surgery
|June 1, 1996
PubMed

Insights

Anticoagulation therapy can safely preserve essential central venous catheters in pediatric patients with catheter-related thrombosis, avoiding removal and potential complications. This approach offers a viable alternative to catheter removal or thrombolytic agents.

Area of Science:

  • Pediatric Thrombosis
  • Vascular Access Devices
  • Hematology

Background:

  • Catheter-related central venous thrombosis (CVC-thrombosis) is a significant complication in pediatric patients requiring central venous access.
  • Traditional management involves anticoagulation and early catheter removal, often necessitating replacement with associated risks.

Purpose of the Study:

  • To evaluate the efficacy and safety of anticoagulation alone for managing catheter-related deep venous thrombosis in children.
  • To determine if anticoagulation can prevent the need for central venous catheter removal.

Main Methods:

  • Retrospective review of 17 pediatric patients (6 weeks to 19 years) treated for CVC-thrombosis between February 1991 and April 1994.
  • Comparison of outcomes between patients undergoing early catheter removal with anticoagulation versus those treated with anticoagulation alone.

Main Results:

  • Seven out of nine patients treated with anticoagulation without catheter removal successfully retained their functional catheters.
  • While one patient required catheter removal due to failed anticoagulation and another due to infection, anticoagulation was effective in preventing removal in the majority.
  • Eight patients underwent early catheter removal, with two requiring it due to intrinsic catheter issues and one due to hemophilia.

Conclusions:

  • Standard anticoagulation therapy is a safe and effective strategy for managing catheter-related deep venous thrombosis in pediatric patients.
  • Preserving functional central venous catheters through anticoagulation can avoid complications associated with catheter removal and replacement.

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