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

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.