Systematic review of anticoagulant treatment of catheter-related thrombosis. Thromb Res 2015 Dec;136(6):1103-9
Date
09/08/2015Pubmed ID
26342400DOI
10.1016/j.thromres.2015.08.020Scopus ID
2-s2.0-84949316352 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
Central venous catheter-related thrombosis (CRT) is a complication seen in patients requiring long-term intravenous access. Treatment of CRT is not standardized and international guidelines for treatment are based on extrapolation of evidence from lower extremity thrombosis. We performed a systematic review of the literature to evaluate if duration of anticoagulation affects the risk of recurrent venous thrombosis, post-thrombotic syndrome, or major hemorrhage. We searched PubMed, Embase, Medline, CINAHL, Cochrane, and ACP Journal club for studies of CRT treated with anticoagulation. Of 1648 titles and abstracts, 23 studies met our inclusion criteria. No randomized trials were identified. Duration of anticoagulation varied from 8 days to more than 6 months. Outcomes of patients with upper extremity thrombosis due to CRT or other etiologies were often combined. The incidence of post-thrombotic syndrome varied between 0 and 75% depending on the definition used. Seven percent of patients with upper extremity thrombosis treated with anticoagulation experienced recurrent deep vein thrombosis and 2.8% experienced pulmonary embolism. Major hemorrhage was reported in 2.8-4.9% of anticoagulated patients. Prospective studies evaluating the optimal duration of anticoagulation in patients with CRT are needed.
Author List
Baumann Kreuziger L, Onwuemene O, Kolesar E, Crowther M, Lim WAuthor
Lisa M. Baumann Kreuziger MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnticoagulantsHumans
Upper Extremity Deep Vein Thrombosis
