Risk of pulmonary emboli after removal of an upper extremity central catheter associated with a deep vein thrombosis.

Autor:	Houghton DE; Division of Vascular Medicine, Department of Cardiovascular Diseases and Division of Hematology/Oncology, Department of Medicine, Mayo Clinic, Rochester, MN., Billett HH; Division of Hematology, Departments of Oncology and Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY., Gaddh M; Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA., Onadeko O; Rollins School of Public Health, Emory University, Atlanta, GA., George G; Division of Hematology, Department of Medicine, University of Colorado, Aurora, CO., Wang TF; Department of Medicine, University of Ottawa at The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada., Oo TH; University of Texas MD Anderson Cancer Center, Houston, TX., Feng M; Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI., Dasgupta M; Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI., Jaglal M; Moffitt Cancer Center, Tampa, FL., Streiff MB; Division of Hematology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD., Simpson P; Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI., Gali R; Montefiore Medical Center, New York, NY; and., Baumann Kreuziger L; Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.; Versiti, Milwaukee, WI.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2021 Jul 27; Vol. 5 (14), pp. 2807-2812.
DOI:	10.1182/bloodadvances.2021004698
Abstrakt:	Standard treatment of catheter-associated upper extremity deep vein thrombosis (UE-DVT) is anticoagulation, although catheters are often removed for this indication. The optimal time for catheter removal and whether the act and/or timing of catheter removal is associated with pulmonary embolism (PE) remain unknown. A retrospective cohort study was performed at 8 participating institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies and central venous catheter (CVC)-associated UE-DVT were included from 1 January 2010 through 31 December 2016. The primary outcome was objectively confirmed PE within 7 days of UE-DVT diagnosis in anticoagulated patients comparing early (≤48 hours) vs delayed (>48 hours) catheter removal. A total of 626 patients were included, among whom 480 were treated with anticoagulation. Among anticoagulated patients, 255 underwent early CVC removal, while 225 had delayed or no CVC removal; 146 patients received no anticoagulation, among whom 116 underwent CVC removal alone. PE within 7 days occurred in 2 patients (0.78%) with early removal compared with 1 patient (0.44%) with delayed or no CVC removal (P > .9). PE or any cause of death within 7 days occurred in 3 patients in both the early removal (1.18%) and delayed/no removal (1.33%) groups (P > .9). In patients treated with CVC removal only (no anticoagulation), there were no PEs but 3 deaths within 7 days. In patients with hematological malignancy and CVC-associated UE-DVT, early removal of CVCs was not associated with an increased risk of PE compared with delayed or no removal. (© 2021 by The American Society of Hematology.)
Databáze:	MEDLINE
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