Catheter-related thrombosis after cardiac surgery in patients with both central venous and pulmonary artery catheters inserted into the right internal jugular vein: a single-center, prospective, observational study

Heart Vessels. 2022 Apr;37(4):691-696. doi: 10.1007/s00380-021-01955-3. Epub 2021 Oct 7.


Central venous catheters (CVCs) and pulmonary artery catheters (PACs) are widely used in intensive care and perioperative management. The detection and prevention of catheter-related thrombosis (CRT) are important because CRT is a complication of catheter use and can cause pulmonary embolism and bloodstream infection. Currently, there is no evidence for CRT in patients using both CVC and PAC. We conducted a single-center, prospective, observational study to identify the incidence, timing, and risk factors for CRT in patients undergoing cardiovascular surgery and using a combination of CVC and PAC through the right internal jugular vein (RIJV). Out of 50 patients, CRT was observed using ultrasonography in 39 patients (78%), and the median time of CRT formation was 1 day (interquartile range: 1-1.5) after catheter insertion. The mean duration of PAC placement was 3 days (interquartile range: 2-5), and the maximum diameter of CRT was 12 mm (interquartile range: 10-15). In short-axis images, CRT occupied more than half of the cross-sectional area of the RIJV in five patients (10%), and CRT completely occluded the RIJV in one patient (2%). Platelet count, duration of PAC placement, and intraoperative bleeding amount were found to be high-risk indicators of CRT. In conclusion, patients who underwent cardiovascular surgery and using both CVC and PAC had a high incidence of CRT. Avoiding unnecessary PAC placement and early removal of catheters in patients at high risk of developing CRT may prevent the development of CRT.

Keywords: Cardiovascular surgery; Catheter-related thrombosis; Central venous catheter; Pulmonary artery catheter; Right internal jugular vein.

Publication types

  • Observational Study

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Catheterization, Central Venous* / adverse effects
  • Central Venous Catheters* / adverse effects
  • Humans
  • Jugular Veins / diagnostic imaging
  • Prospective Studies
  • Pulmonary Artery / diagnostic imaging
  • Thrombosis* / etiology