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Thrombin activity associated with indwelling central venous catheters

C W Francis1, A H Felcher, J White

  • 1Department of Medicine, University of Rochester School of Medicine & Dentistry, New York, USA.

Thrombosis and Haemostasis
|January 1, 1997
PubMed

Insights

Central venous catheters often develop thrombin activity, leading to complications. Hirudin effectively inactivates this catheter-associated thrombin, suggesting its therapeutic potential for preventing thrombotic events.

Area of Science:

  • Biomedical Engineering
  • Hematology
  • Vascular Biology

Background:

  • Indwelling central venous catheters are prone to thrombotic complications, causing dysfunction and infection.
  • The exact mechanisms of catheter-related thrombosis are not fully understood but involve vessel damage, stasis, and thrombin generation.
  • Thrombin plays a critical role in the pathogenesis of catheter-associated thrombosis.

Purpose of the Study:

  • To quantify thrombin activity on removed central venous catheters.
  • To assess the efficacy of hirudin in inactivating catheter-associated thrombin.
  • To investigate the relationship between catheter material and thrombin deposition.

Main Methods:

  • Collected 48 central venous catheters from 46 patients.
  • Sectioned catheters (distal, 5 cm, 15 cm proximal) for analysis.
  • Measured thrombin activity using a chromogenic assay and assessed inhibition by hirudin.
  • Utilized scanning electron microscopy to visualize fibrin deposition.

Main Results:

  • Thrombin activity was detected on 40 out of 48 catheters (100 out of 144 segments).
  • Mean thrombin activity was 132 +/- 27 microU/cm, with significant variability.
  • Hirudin treatment reduced thrombin activity by over 85% (p < .001).
  • Scanning electron microscopy revealed fibrin deposition not visible to the naked eye.

Conclusions:

  • Indwelling central venous catheters frequently harbor active thrombin.
  • This thrombin activity can be effectively inhibited by direct-acting agents like hirudin.
  • Targeting catheter-associated thrombin may offer a strategy to mitigate thrombotic complications.

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