Port-A-Cath–Related Thrombosis and Postthrombotic Syndrome in Pediatric Oncology Patients

Albisetti, Manuela; Kellenberger, Christian J.; Bergsträßer, Eva; Niggli, Felix; Kroiss, Sabine; Rizzi, Mattia; Schmugge, Markus

doi:10.1016/j.jpeds.2013.06.076

Cited by 47 publications

(52 citation statements)

References 32 publications

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“…However, the most important risk factor is the presence of a CVC, which is composed of thrombogenic material and obstructs venous flow and irritates the vessel wall (31). In a single-center study, children with malignancy and a port-a-cath, younger age, female sex, prolonged duration of a port-a-cath, and a left-sided device were independent risk factors for CVC-VTE (32). …”

Section: Resultsmentioning

confidence: 99%

The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

2017

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The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs. non-tunneled vs. peripherally inserted vs. implanted), catheter material, insertion technique, or insertion location lead to an increased VTE risk. The patient populations who were found to be most at risk for CVC-VTE were those with cancer, congenital heart disease, gastrointestinal failure, systemic infection, intensive care unit admission, or involved in a trauma. Both mechanical and pharmacological prophylactic techniques have been shown to be successful in preventing VTE in adult patients, but studies in children have yet to be performed or are underpowered. In order to better determine true CVC-VTE risk factors and best preventative techniques, an increase in large, prospective pediatric trials needs to be performed.

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Section: Resultsmentioning

confidence: 99%

The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

2017

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“…However, other clinical risk factors, such as malignancy, cardiac disease, and NS, contribute to thrombotic risk as well. 2 The presumed impact of inherited thrombophilia on the thrombotic risk of CVC-related VTE in children is challenged by results 25 In addition, in the KIDs with Catheter Associated Thrombosis study, which included 90 children with heart disease requiring CVCs in the upper venous system for perioperative care, none of the thrombophilic factors showed a significant association with CVC-related VTE. 26 VTE is one of the most serious complications in children with NS, which is attributed to a net shift in the hemostatic balance toward a hypercoagulable state by selective loss of hemostatic proteins, most notably PS and AT.…”

Section: Thrombophilia In Childrenmentioning

confidence: 99%

“…26 VTE is one of the most serious complications in children with NS, which is attributed to a net shift in the hemostatic balance toward a hypercoagulable state by selective loss of hemostatic proteins, most notably PS and AT. 25 The reported incidence of VTE in children with NS varies between 9% and 36% based on recent literature. 27,28 Age $12 years at onset, severe proteinuria, and history of VTE prior to diagnosis of NS were significant independent predictors of VTE.…”

Section: Thrombophilia In Childrenmentioning

confidence: 99%

Manifestations and clinical impact of pediatric inherited thrombophilia

Klaassen

Ommen

2015

Blood

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The etiology of pediatric venous thromboembolic disease (VTE) is multifactorial, and in most children, 1 or more clinical risk factors are present. In addition, inherited thrombophilic disorders contribute to the development of pediatric VTE. In this review, the role of inherited thrombophilic disorders in the development of pediatric VTE, as well as the benefits and limitations of thrombophilia testing, will be discussed.

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“…An important limitation of the above-mentioned meta-analysis was that patient subgroups like provoked or unprovoked, neonatal VTE, and catheter-related VTE could not be analyzed separately due to small groups, and unclear definitions in the original studies. Nevertheless, other studies showed that the prevalence of inherited thrombophilia seems to be higher in adolescents with unprovoked thrombosis and in children with a positive family history for VTE and lower in children with cardiac disease or malignancy with catheter-related thrombosis (21–24). In neonates with catheter-related thrombosis, only a few small studies investigated the prevalence of thrombophilia defects, which were rarely found (25–27).…”

Section: Why Should We Test For Inherited Thrombophilia In Children Wmentioning

confidence: 96%

Inherited Thrombophilia in Pediatric Venous Thromboembolic Disease: Why and Who to Test

Ommen

Nowak‐Göttl²

2017

Front. Pediatr.

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Venous thromboembolic disease in childhood is a multifactorial disease. Risk factors include acquired clinical risk factors such as a central venous catheter and underlying disease and inherited thrombophilia. Inherited thrombophilia is defined as a genetically determined tendency to develop venous thromboembolism. In contrast to adults, acquired clinical risk factors play a larger role than inherited thrombophilia in the development of thrombotic disease in children. The contributing role of inherited thrombophilia is not clear in many pediatric thrombotic events, especially catheter-related thrombosis. Furthermore, identification of inherited thrombophilia will not often influence acute management of the thrombotic event as well as the duration of anticoagulation. In some patients, however, detection of inherited thrombophilia may lead to identification of other family members who can be counseled for their thrombotic risk. This article discusses the potential arguments for testing of inherited thrombophilia, including factor V Leiden mutation, prothrombin mutation, and deficiencies of antithrombin, protein C, or protein S and suggests some patient groups in childhood, which may be tested.

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Port-A-Cath–Related Thrombosis and Postthrombotic Syndrome in Pediatric Oncology Patients

Cited by 47 publications

References 32 publications

The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

Manifestations and clinical impact of pediatric inherited thrombophilia

Inherited Thrombophilia in Pediatric Venous Thromboembolic Disease: Why and Who to Test

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