How i treat central venous access device-related upper extremity deep vein thrombosis

Anita Rajasekhar, Michael B Streiff

Research output: Contribution to journalArticle

Abstract

Central venous access device (CVAD)- related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access, and postthrombotic syndrome. Patient-, device-, and treatmentrelated factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for the prevention of CRT remains to be established. Therefore, minimizing patient exposure to known risk factors is the best available approach to prevent CRT. Venous duplex is recommended for the diagnosis of CRT. Anticoagulation for at least 3 months or the duration of the indwelling CVAD is recommended for treatment of CRT. Thrombolysis should be considered for patients at low risk for bleeding who have limb-threatening thrombosis or whose symptoms fail to resolve with adequate anticoagulation. CVAD removal should be consider for patients with bacteremia, persistent symptoms despite anticoagulation, and if the CVAD is no longer needed. Superior vena cava filters should be avoided. Prospective studies are needed to define the optimal management of patients with or at risk for CRT.

Original languageEnglish (US)
Pages (from-to)2727-2736
Number of pages10
JournalBlood
Volume129
Issue number20
DOIs
StatePublished - May 18 2017

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Upper Extremity Deep Vein Thrombosis
Thrombosis
Equipment and Supplies
Health care
Postthrombotic Syndrome
Device Removal
Vena Cava Filters
Superior Vena Cava
Bacteremia
Pulmonary Embolism
Venous Thrombosis
Extremities
Randomized Controlled Trials
Prospective Studies

ASJC Scopus subject areas

  • Immunology
  • Biochemistry
  • Hematology
  • Cell Biology

Cite this

How i treat central venous access device-related upper extremity deep vein thrombosis. / Rajasekhar, Anita; Streiff, Michael B.

In: Blood, Vol. 129, No. 20, 18.05.2017, p. 2727-2736.

Research output: Contribution to journalArticle

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