Central catheter-associated deep vein thrombosis in cancer: clinical course, prophylaxis, treatment

BMJ Support Palliat Care. 2021 Dec;11(4):371-380. doi: 10.1136/bmjspcare-2019-002106. Epub 2021 Aug 19.

Abstract

The adequate handling of central venous catheters is a key element in the management of patients with cancer. Catheter-associated deep vein thrombosis is frequently observed in patients with malignant diseases; however, despite being a common complication among these patients, objective information concerning its epidemiology, clinical course, prophylaxis and treatment strategies is very limited. The reported incidence of catheter-related thrombosis (CRT) is highly variable, depending on symptomatic events, or if patients are screened for asymptomatic thrombosis. Several factors have been identified as potential predisposing factors for CRT, both technical and pathological aspects. The anticoagulant of choice is still unclear; while low-molecular-weight heparin is most commonly used, recent studies assessing the role of direct oral anticoagulants in the treatment of CRT show promise as an alternative, but the evidence remains insufficient and the decision must be made on a case-by-case basis.

Keywords: cancer; clinical assessment; clinical decisions; drug administration; venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Central Venous Catheters*
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Neoplasms* / complications
  • Risk Factors
  • Venous Thrombosis* / drug therapy
  • Venous Thrombosis* / epidemiology
  • Venous Thrombosis* / etiology

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight