Central venous catheter‐associated thrombosis in severe haemophilia

Vidler, Vicky; Richards, Matthew; Vora, Ajay

doi:10.1046/j.1365-2141.1999.01222.x

Cited by 45 publications

(50 citation statements)

References 9 publications

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“…In-dwelling catheter thrombosis is a frequent complication in normal subjects and also in haemophilia patients [6,7]. This seems to indicate that, in given circumstances, even a clotting defect, often a severe one, cannot prevent venous thrombosis to occur if mechanical devices irritate the venous endothelium.…”

Section: Introductionmentioning

confidence: 95%

Non-catheter associated venous thrombosis in hemophilia A and B. A critical review of all reported cases

Girolami

Scandellari

Zanon

et al. 2006

J Thromb Thrombolysis

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All reported cases of non-catheter induced venous thrombosis in patients with hemophilia A or B have been carefully evaluated. A total of 27 cases were reported,12 patients with hemophilia A and 15 patients with hemophilia B. The age of patients varied between 9 and 67 years. There were 10 cases of deep vein thrombosis, 8 patients with pulmonary embolism accompanied or not by deep vein thrombosis, 5 cases of superficial vein thrombosis. In addition, there were 3 cases of thrombosis in unusual sites (1 retinal central vein thrombosis and 2 portal vein thrombosis). Finally, in one case, venous thrombosis was multiple. There was a fatality in a hemophilia B patient with pulmonary embolism. The most frequent risk or triggering factor in hemophilia A was the administration of Feiba or rFVIIa concentrates in patients with inhibitors. Surgery together with Prothrombin Complex concentrates was the most frequent cause in hemophilia B patients. Congenital associated prothrombotic risk factors were present in two patients. No or very few therapeutic procedures were initiated in these patients but for a suspension or reduction of concentrates infusion. In a few instances low molecular weight heparin was given for a few days. The frequent association of venous thrombosis with infusion of concentrates indicates the need for a careful evaluation of patients about to receive such therapy.

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Section: Introductionmentioning

confidence: 95%

Non-catheter associated venous thrombosis in hemophilia A and B. A critical review of all reported cases

Girolami

Scandellari

Zanon

et al. 2006

J Thromb Thrombolysis

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“…Some series have reported a high frequency of abnormalities on venograms [20]. In the series by Journeycake et al [22] and also a case of bacterial endocarditis [23]. The risk of thrombosis in haemophilia patients seems to justify only routine clinical surveillance of this potential complication.…”

Section: Thrombosismentioning

confidence: 99%

Central venous lines in haemophilia

Ljung

2003

Haemophilia

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Summary. Infections and technical problems are the most frequent complications when using implantable central venous access devices in patients with haemophilia. There are two major experiences reported concerning infections in noninhibitor patients: one is approximately 0.2 infections per 1000 days and the other approximately 1.0 (0.7–1.6) per 1000 days. Infections are more frequent in inhibitor patients and approximately one infection per 6–12 months of use can be expected. The figures are low for clinically apparent thrombosis in the larger series on record, but routine venograms were not carried out in most of these series. In studies where this has been done, a high frequency of abnormalities on venograms has been seen in some but not in others. The final decision to use a central line has to take into account the medical goal, the patient's bleeding tendency, the social situation and the expected risk of complications at the particular haemophilia centre. Some of the complications may be reduced by adequate aseptic measures both during implantation and in subsequent use, and by clear basic routines for surveillance of the systems and repeated education of the users.

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“…Vidler and colleagues reported 2 patients with severe hemophilia and an inhibitor who had CVC-related DVT. 17 Both were treated with high-dose factor infusions and one with an activated prothrombin complex concentrate (PCC). The authors speculated that high-dose factor and procoagulant PCC therapy might have promoted thrombus formation.…”

Section: Discussionmentioning

confidence: 99%

“…14 None had definitive radiographic evidence of DVT in the upper venous system (the subclavian, brachiocephalic, or jugular veins, or the superior vena cava) despite having had catheters in place for 10 to 60 months (mean, 23 months). However, a recent abstract 15 and several case studies 16,17 indicate that thrombosis does occur in patients with hemophilia. Because we recently identified thrombi in several of our patients, we further investigated this issue.…”

Section: Introductionmentioning

confidence: 99%

Catheter-related deep venous thrombosis in children with hemophilia

Journeycake

Quinn

Miller

et al. 2001

Blood

109

141

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Central venous catheters (CVCs) are a common adjunct to hemophilia therapy, but the risk of CVC-related deep venous thrombosis (DVT) in hemophiliacs is not well defined. In a previous study, 13 patients with CVCs had no radiographic evidence of DVT. However, recent abstracts and case studies demonstrate that DVT does occur. Therefore, this study sought to determine the frequency of DVT in children with hemophilia and long-term CVCs and to correlate venographic findings with clinical features. All hemophilia patients with tunneled subclavian CVCs in place for 12 months or more were candidates for evaluation. Patients were examined for physical signs of DVT and questioned about catheter dysfunction. Contrast venograms were obtained to identify DVT. Fifteen boys with severe hemophilia were evaluated, including 9 from the initially studied group of 13. Eight patients had evidence of DVT, 5 of whom previously had normal venograms.

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Central venous catheter‐associated thrombosis in severe haemophilia

Cited by 45 publications

References 9 publications

Non-catheter associated venous thrombosis in hemophilia A and B. A critical review of all reported cases

Non-catheter associated venous thrombosis in hemophilia A and B. A critical review of all reported cases

Central venous lines in haemophilia

Catheter-related deep venous thrombosis in children with hemophilia

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