Catheter-Related Thrombosis in Cancer

Author(s):  
Prajwal Dhakal
2021 ◽  
pp. 112972982110087
Author(s):  
Junren Kang ◽  
Wenyan Sun ◽  
Hailong Li ◽  
En ling Ma ◽  
Wei Chen

Background: The Michigan Risk Score (MRS) was the only predicted score for peripherally inserted central venous catheters (PICC) associated upper extremity venous thrombosis (UEVT). Age-adjusted D-dimer increased the efficiency for UEVT. There were no external validations in an independent cohort. Method: A retrospective study of adult patients with PICC insertion was performed. The primary objective was to evaluate the performance of the MRS and age-adjusted D-dimer in estimating risk of PICC-related symptomatic UEVT. The sensitivity, specificity and areas under the receiver operating characteristics (ROC) of MRS and age-adjusted D-dimer were calculated. Results: Two thousand one hundred sixty-three patients were included for a total of 206,132 catheter days. Fifty-six (2.6%) developed PICC-UEVT. The incidences of PICC-UEVT were 4.9% for class I, 7.5% for class II, 2.2% for class III, 0% for class IV of MRS ( p = 0.011). The incidences of PICC-UEVT were 4.5% for D-dimer above the age-adjusted threshold and 1.5% for below the threshold ( p = 0.001). The areas under ROC of MRS and age-adjusted D-dimer were 0.405 (95% confidence interval (CI) 0.303–0.508) and 0.639 (95% CI 0.547–0.731). The sensitivity and specificity of MRS were 0.82 (95% CI, 0.69–0.91), 0.09 (95% CI, 0.08–0.11), respectively. The sensitivity and specificity of age-adjusted D-dimer were 0.64 (95% CI, 0.46–0.79) and 0.64 (95% CI, 0.61–0.66), respectively. Conclusions: MRS and age-adjusted D-dimer have low accuracy to predict PICC-UEVT. Further studies are needed.


1995 ◽  
Vol 126 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Brian Krafte-Jacobs ◽  
Carlos J. Sivit ◽  
Rodrigo Mejia ◽  
Murray M. Pollack

2017 ◽  
Vol 4 (12) ◽  
pp. 1898-1910
Author(s):  
ANBAR Ruchan ◽  
AVCI Deniz ◽  
CETİNKAYA Ali

Background: We provided a comparative presentation of complications seen in 114 patients with port catheter implantation. In addition, we addressed whether patients with catheter-related thrombosis have distinctive features by assessing patients who developed thrombosis either at the catheter implant site or vascular bed. Methods: In this study, we analyzed data from 114 patients who underwent subclavian venous port catheter implantation by a single surgeon at Kayseri Teaching Hospital (Turkey) during 2013 to 2016. Subclavian port catheter was inserted in all cases. The diagnosis of port thrombosis was made by Doppler sonography or thorax CT scan with contrast enhancement in patients presenting with edema at upper extremity, swelling or pain at neck, and/or dysfunctional port. Results: Seroma was detected in only one case, lymphedema developed in one case (0.8%), and pneumothorax was observed in 3 cases. The subclavian vein was implanted on the right side in all patients with pneumothorax. None of these cases were associated with thrombosis. Port infection was observed in one case (0.8%). There was also one case (0.8%) of skin necrosis. The port was removed in 15 patients due to several reasons, which are indicated in Table 2. Thromboembolic events were observed in 11 of the 114 patients while port thrombosis was observed in 7 patients. The rate of hypertension in the thromboembolism group was 61.1% (11/18 individual) while the rate of hypertension in the group without thromboembolism was 28.1% (27/96 individuals); this difference was statistically significant (p = 0.006). Conclusion: In this study, based on complications observed in patients with catheter-related thrombosis, factors such as smoking or diabetes mellitus were seen to be linked to thromboembolism and should be taken into consideration. Moreover, it was observed that hypertension had a significant association with thromboembolism.


2021 ◽  
Vol 11 (7) ◽  
pp. 1979-1984
Author(s):  
Zeyong Huang ◽  
Wei Chen ◽  
Shuping Zhang ◽  
Tingting Zhao ◽  
Ying Fan ◽  
...  

Objective: In order to explore the clinical application effect of the upper arm venous infusion port, analyze the prevention and treatment effect of catheter rupture of the upper arm venous infusion port, and conduct a series of studies on postoperative related complications, as well as analyze the prevention and treatment of catheter rupture of the upper arm venous infusion port effect using chest radiography and computed tomography. Methods: We collected clinical data of 98 patients implanted in the upper arm venous infusion port in the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine and Hangzhou Shulan Hospital from January to December 2017, divided the 98 patients into two groups, and gave 49 patients in group A Based on the patient’s basic intervention, 49 patients in group B were given prevention and treatment intervention of catheter rupture, and the intervention effects of the two groups were compared. Consult the nursing records during the hospitalization and maintenance period after the implantation of the upper arm vein infusion port, summarize the complications, analyze the causes, and discuss the formulation of feasible nursing countermea-sures. Results: 98 patients were followed up for 5-16 months, with a median follow-up time of 10 months. Within 2 weeks after implantation of the upper arm vein infusion port and during discharge maintenance, the incidence of complications was 24.49% (24/98), 8.16% (8/98), the difference in the incidence of complications between the two time periods was statistically significant (P < 0.05). Among them, common complications include incision bleeding at the port body, poor healing of the incision, local swelling, obstruction of catheter withdrawal, extravasation of transfusion at the port body, catheter blockage, catheter displacement, and catheter-related thrombosis. There was a difference in the incidence of catheter rupture, catheter rupture time, and patient satisfaction after intervention between the two groups of intravenous implantation patients (P < 0.05), which was statistically significant. Conclusions: Complications within 2 weeks after implantation of the upper arm venous infusion port are significantly higher than the maintenance period. Among them, infusion extravasation, catheter-related thrombosis, catheter blockage, and catheter displacement at the port body are serious complications that directly affect the use of the upper arm infusion port . The prevention and treatment of catheter rupture for patients who have used implanted intravenous infusion ports for a long time has significant effects, which can reduce the occurrence of catheter rupture and ensure the safety of patients’ lives and health.


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