Patient Characteristics and Treatment Outcomes of Symptomatic Catheter-Related Arterial Thrombosis in Infants: A Retrospective Cohort Study
| Autor: | Athis Arunachalam, Mubbasheer Ahmed, Viia Anderson, Rosa E. Diaz, Sudhen B Desai, Clay T. Cohen |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty medicine.drug_class medicine.medical_treatment Low molecular weight heparin Cohort Studies 03 medical and health sciences Catheters Indwelling 0302 clinical medicine 030225 pediatrics medicine Humans 030212 general & internal medicine Thrombus Prospective cohort study Retrospective Studies Cardiac catheterization business.industry Infant Newborn Anticoagulants Infant Thrombosis Retrospective cohort study Arterial catheter medicine.disease Surgery Catheter Treatment Outcome Pediatrics Perinatology and Child Health Female business |
| Zdroj: | The Journal of Pediatrics. 231:215-222 |
| ISSN: | 0022-3476 |
| Popis: | To describe the clinical characteristics, outcomes, and adverse events of treatment for symptomatic infant catheter-related arterial thrombosis.Single-center retrospective medical record review of 99 infants (age365 days) with catheter-related arterial thrombosis, either following indwelling arterial catheter placement or cardiac catheterization, who were treated with anticoagulation over an 8-year span at a pediatric tertiary care center. Outcomes measured include thrombosis progression, bleeding events, and thrombus resolution following the treatment period.Thromboses were secondary to indwelling arterial catheter placement in 51 (51.5%) and cardiac catheterization in 48 (48.5%). The median age at diagnosis of catheter-related arterial thrombosis was 52 days. All patients received therapeutic anticoagulation with either unfractionated heparin or low molecular weight heparin for a maximum of 28 days. Progression of catheter-related arterial thrombosis occurred in 8 (8.1%) patients. One (1%) major and 3 (3%) minor bleeding events occurred within the cohort. Complete thrombus resolution was observed in 60 (60.6%), partial resolution in 33 (33.3%), and no resolution in 6 (6.1%) following the treatment period. Factors associated with complete thrombus resolution included time from intervention to catheter-related arterial thrombosis diagnosis (median of 1 day vs 5 days in those who experienced thrombus resolution vs those who did not, P = .035), and iliac and/or femoral artery involvement (P = .015).Our treatment approach to infant catheter-related arterial thrombosis is safe and effective. Limitations of the study are its retrospective nature with a limited number of patients from a single institution. Additional prospective studies are needed to determine the optimal treatment approach to catheter-related arterial thrombosis in infants. |
| Databáze: | OpenAIRE |
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