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Systematic review of anticoagulant treatment of catheter-related thrombosis.

Abstract：

: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.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Baumann Kreuziger L,Onwuemene O,Kolesar E,Crowther M,Lim W

doi

10.1016/j.thromres.2015.08.020

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1103-9

issue

6

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(15)30103-1

journal_volume

136

pub_type

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