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Catheter related thrombosis

Maxim Yu Rykov, Sergei V Zaborovskij, Alexander N Shvecov, Vladimir V Shukin
PURPOSE: To review our experience with peripherally inserted central catheters in pediatric cancer patients. METHODS: The analysis included 353 patients (3 months up to 17 years, mean age 11.2 years) with a variety of cancers diseases, which in 2011-2016, 354 peripherally inserted central catheters were placed. All settings are carried out using ultrasound guidance. In 138 (39%) patients, external anatomical landmarks were used and in 216 (61%) intraoperative fluoroscopy...
March 1, 2018: Journal of Vascular Access
James C Barton, Jackson Clayborn Barton, Luigi F Bertoli
BACKGROUND: We sought to learn more about the utility and safety of implanted ports for monthly immunoglobulin G infusions in adults with primary immune deficiency. METHODS: We reviewed charts of adults who were referred to a single practice during the interval 2006-2016 for evaluation and management of frequent or severe upper and lower respiratory tract and other infections, subnormal total immunoglobulin G or immunoglobulin G subclasses, and suboptimal responses to polyvalent pneumococcal polysaccharide vaccinations; were diagnosed to have primary immune deficiency; and were advised to undergo immunoglobulin G therapy...
March 1, 2018: Journal of Vascular Access
Ammara Mushtaq, Bhagyashri Navalkele, Maninder Kaur, Amar Krishna, Aleena Saleem, Natasha Rana, Sonia Gera, Suganya Chandramohan, Malini Surapaneni, Teena Chopra
BACKGROUND: With the rising use of midline catheters (MCs), validation of their safety is essential. Our study aimed to evaluate the incidence of bloodstream infections (BSIs) and other complications related to the use of MCs and central venous catheters (CVCs). METHODS: A retrospective cohort study was performed at a tertiary care hospital in Detroit, Michigan, from March-September 2016. Adult patients with either MC or CVC were included. Outcomes assessed were catheter-related BSI (CRBSI), mechanical complications, hospital length of stay, readmission within 90 days of discharge (RA), and mortality...
March 7, 2018: American Journal of Infection Control
O Mahmoud, P Vikatmaa, J Räsänen, E Peltola, E Sihvo, L Vikatmaa, K Lappalainen, M Venermo
BACKGROUND AND AIMS: We compared the immediate and one-year results as well as total hospital costs between catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of symptomatic upper extremity deep venous thrombosis (UEDVT). MATERIAL AND METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital. Of them, 43 underwent thoracoscopic rib resection later in order to relieve phlebography-confirmed vein compression...
March 6, 2018: Annals of Vascular Surgery
Kiyoshi Tamura, Toshiyuki Maruyama
Objective : Endovenous radiofrequency ablation (RFA), a relatively new technique for treating great saphenous varicose veins, is less invasive compared with stripping surgery. This study examined the mid-term safety and effectiveness of RFA for varicose veins. Materials and Methods : We enrolled 104 patients (147 limbs) who underwent RFA for varicose veins of the lower extremities (females, 67; 64.4%). The mean age was 68.9±9.2 years (39-85 years). In 121 limbs (82.3%), there were great saphenous veins. All patients were observed as outpatients for 12 months after the procedure...
December 25, 2017: Annals of Vascular Diseases
Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
Cory M McLaughlin, Monica Bennett, Nandini Channabasappa, Janna Journeycake, Hannah G Piper
PURPOSE: The purpose of this study was to investigate whether anticoagulation (AC) results in thrombus resolution and increased line longevity in children with intestinal failure (IF) and catheter-associated central venous thrombosis (CVT). METHODS: A retrospective, single institution review was performed of children with IF who were dependent on parenteral nutrition with known CVT between 2006 and 2017. Frequency of catheter-related complications including infection, occlusion, and breakage were compared 18months prior to and after starting AC...
February 7, 2018: Journal of Pediatric Surgery
Emily N Israel, Christopher A Thomas, Christopher W Mastropietro
BACKGROUND: Enoxaparin may be used to prevent central venous catheter-related thrombosis in patients with CHD. We aimed to determine whether current enoxaparin dosing regimens effectively achieve anti-factor Xa concentrations within prophylactic goal ranges in this patient population. METHODS: We implemented a formal protocol aimed at reducing central venous catheter-related thrombosis in children with CHD in January, 2016. Standard empiric prophylactic enoxaparin dosing regimens were used - for example, 0...
March 1, 2018: Cardiology in the Young
Tze Hung Siah, Alexander Chapman
A 33-year-old, 8-week pregnant woman presented with mottling, pain and swelling of her left leg. Ultrasound Doppler scan revealed a large left iliofemoral deep vein thrombosis and the patient was diagnosed with phlegmasia cerulea dolens. After 24 hours of treatment with unfractionated heparin, there were minimal improvements in her symptoms. Catheter-directed thrombolysis was performed, following multidisciplinary consultation with the patient. An underlying May-Thurner lesion was identified and successfully stented...
February 27, 2018: BMJ Case Reports
Jeanine J Sol, Moniek van de Loo, Marit Boerma, Klasien A Bergman, Albertine E Donker, Mark A H B M van der Hoeven, Christiaan V Hulzebos, Ronny Knol, K Djien Liem, Richard A van Lingen, Enrico Lopriore, Monique H Suijker, Daniel C Vijlbrief, Remco Visser, Margreet A Veening, Mirjam M van Weissenbruch, C Heleen van Ommen
BACKGROUND: In critically ill (preterm) neonates, central venous catheters (CVCs) are increasingly used for administration of medication or parenteral nutrition. A serious complication, however, is the development of catheter-related thrombosis (CVC-thrombosis), which may resolve by itself or cause severe complications. Due to lack of evidence, management of neonatal CVC-thrombosis varies among neonatal intensive care units (NICUs). In the Netherlands an expert-based national management guideline has been developed which is implemented in all 10 NICUs in 2014...
February 23, 2018: BMC Pediatrics
Wen-Chun Chen, Shuo-Ming Ou
Nephrotic syndrome is a well-known risk factor of deep vein thrombosis (DVT). Catheter-related DVT under the setting of nephrotic syndrome may be presented as a more fulminant form, phlegmasia cerulea dolens. Phlegmasia cerulea dolens may lead to severe obstruction of venous drainage of the extremities and presents with compartment syndrome that impairs arterial perfusion. Aggressive management with thrombolysis and/or thrombectomy are considered with simultaneous anticoagulant treatment.
February 13, 2018: Hemodialysis International
Yadong Shi, Wanyin Shi, Liang Chen, Jianping Gu
To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened...
February 7, 2018: Journal of Thrombosis and Thrombolysis
Drew Fleck, Hassan Albadawi, Fadi Shamoun, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Anticoagulation therefore does little to prevent the venous damage and scarring that occurs following DVT, leaving the patient at risk for permanent venous insufficiency and development of post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
Mick Kumwenda, Lisa Dougherty, Helen Spooner, Victoria Jackson, Sandip Mitra, Nicholas Inston
Tunnelled central venous access devices (CVADs) are defined as any intravenous multipurpose catheters placed within the central veins for use in haemodialysis and administration of blood products or chemotherapy in oncology and haematological conditions. Frequent complications include thrombosis and catheter-related infection, which may lead to significant adverse patient outcomes. Once thrombosis is suspected correction should be attempted empirically with thrombolytic agents. Commonly available thrombolytic agents in the UK include urokinase (Syner-Kinase) and alteplase (Cathflo)...
January 25, 2018: British Journal of Nursing: BJN
Goutham Talari, Preetham Talari, Saurabh Parasramka, Aibek E Mirrakhimov
Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea-azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay...
January 23, 2018: BMJ Case Reports
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
March 2018: European Journal of Pediatrics
Suresh Vedantham, Akhilesh K Sista
Patients who present with severe manifestations of acute venous thromboembolism (VTE) are at higher risk for premature death and long-term disability. In recent years, catheter-based interventional procedures have shown strong potential to improve clinical outcomes in selected VTE patients. However, physicians continue to be routinely faced with challenging decisions that pertain to the utilization of these risky and costly treatment strategies, and there is a relative paucity of published clinical trials with sufficient rigor and directness to inform clinical practice...
February 15, 2018: Blood
Minming Wu, Yao Chen, Bin Du, Yan Kang
INTRODUCTION: Catheter use is associated with many complications and is an iatrogenic source of morbidity and mortality in intensive care units (ICU). The catheter being studied (Certofix Protect) was developed to reduce the risk of catheter related infections. This clinical trial will compare the safety and efficiency of Certofix Protect with that of an ordinary Certofix catheter. METHODS AND ANALYSIS: In this multicentre trial, we will randomly assigned dual lumen central venous catheterisation (≥5 ds) in patients in the adult ICU to the antimicrobial central venous catheter (CVC) group or the ordinary CVC group...
December 29, 2017: BMJ Open
Olivier Andremont, Damien du Cheyron, Nicolas Terzi, Cedric Daubin, Amélie Seguin, Xavier Valette, Flore-Anne Lecoq, Jean-Jacques Parienti, Bertrand Sauneuf
BACKGROUND: Targeted temperature management (TTM) contributes to improved neurological outcome in adults who have been successfully resuscitated after cardiac arrest with shockable rhythm. Endovascular cooling catheters are widely used to induce and maintain targeted temperature in the ICU. The aim of the study was to compare the risk of complications with cooling catheters and standard central venous catheters. MATERIALS AND METHODS: In this prospective single-centre cohort study, we included all patients admitted to an intensive care unit for successfully resuscitated cardiac arrest that required endovascular TTM (Coolgard®, Zoll™ Medical corporation, MA, USA), between August 2012 and November 2014, inclusive...
December 11, 2017: Resuscitation
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