Prevention and treatment of thrombosis associated with central venous catheters in cancer patients

Expert Rev Hematol. 2014 Oct;7(5):599-616. doi: 10.1586/17474086.2014.954541. Epub 2014 Aug 31.

Abstract

Central venous catheters (CVC) play an essential role in the management of cancer patients. Venous thrombosis is a common complication of CVC. The incidence of CVC-associated venous thromboembolism (CVC-VTE) is 1.7 per 1000 catheter days. Risk factors for CVC-VTE include the patient's underlying cancer, a history of previous thrombotic events and the location and type of CVC. Anticoagulant prophylaxis is not effective for CVC-VTE. Anticoagulation alone is the preferred initial treatment for CVC-VTE. CVC removal may be considered in refractory cases or when anticoagulation is contraindicated. Thrombolytic therapy is reserved for patients with limb-threatening thrombosis or thrombosis unresponsive to conventional treatment. Anticoagulation should be continued for at least 3 months or as long as the CVC is present.

Keywords: anticoagulation; cancer; central venous access device; central venous catheter; prevention; prophylaxis; treatment.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Central Venous Catheters
  • Clinical Trials as Topic
  • Humans
  • Neoplasms / complications*
  • Risk Factors
  • Thrombosis / complications
  • Thrombosis / drug therapy*
  • Thrombosis / prevention & control

Substances

  • Anticoagulants