Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (7): 63-67.doi: 10.6040/j.issn.1671-7554.0.2020.1717

Previous Articles    

Value of regular ultrasound examination in the diagnosis and treatment of deep venous thrombosis associated with central venous access device

WANG Ning1, GUO Zhenjiang2, ZHANG Yuanyuan3, WANG Jing1, GUO Wei1, WANG Jinrong1, CUI Zhaobo1   

  1. 1. Department of Respiration;
    2. Department of General Surgery;
    3. Department of Pharmacy, Harrsion International Peace Hospital, Hengshui 053000, Hebei, China
  • Published:2021-07-16

PDF (PC)

45

Abstract: Objective To evaluate the value of regular ultrasound examination in the diagnosis and treatment of deep vein thrombosis associated with central venous access device(CVAD). Methods A total of 440 cancer patients with CAVD treated in Harrsion International Peace Hospital during May 2018 and Sep. 2019 were randomly divided into the observation group(n=221)and observation group(n=219). The observation group received ultrasound examination every 3 weeks to detect the presence of CVAD-related deep venous thrombosis(CRDVT), while the control group received ultrasound examination when clinical symptoms appeared. The patients with CRDVT diagnosed in the two groups were evaluated with ultrasound for no less than 90 days until CVAD was removed, and the thrombosis recurrence during this period was recorded. The diagnostic rate of CRDVT, rate of unplanned CVAD removal, rate of thrombosis recurrence and incidence of post thrombotic syndrome(PTS)were compared between the two groups. Results There was no significant difference in the basic data between the two groups(P>0.05). The diagnostic rate of CRDVT was 9.5%(21 cases)in the observation group and 4.6%(10 cases)in the control group(χ2=4.092, P=0.043). The rate of unplanned CVAD removal was 0.9%(2 cases)in the observation group and 4.1%(9 cases)in the control group(χ2=4.634, P=0.031). The cumulative thrombosis recurrence rate of CRDVT patients in 90 days was 15.3% in the observation group and 10.0% in the control group(Logrank=0.003, P=0.953). The incidence of PTS was 4.7% in the observation group and 40% in the control group(χ2=3.886, P=0.049). Conclusion Regular ultrasonic examination can improve the diagnostic rate of CRDVT and reduce the rate of unplanned CVAD removal and PTS incidence.

Key words: Vascular access devices, Catheters, Upper extremity deep vein thrombosis, Venous thrombosis, Neoplasms

CLC Number: 

  • R574
[1] Zhou X, Lin X, Shen R, et al. A retrospective analysis of risk factors associated with catheter-related thrombosis: a single-center study [J]. Perfusion, 2020, 35(8): 806-813.
[2] 李慧妍, 邵群, 张志仁. 导管相关性血栓研究进展[J]. 肿瘤综合治疗电子杂志, 2019, 5(3): 8-12. LI Huiyan, SHAO Qun, ZHANG Zhiren. Progress of catheter-related thrombosis [J]. Journal of Multidisciplinary Cancer Management(Electronic Version), 2019, 5(3): 8-12.
[3] Taxbro K, Hammarskjöld F, Thelin B, et al. Clinical impact of peripherally inserted central catheters vs implanted port catheters in patients with cancer: an open-label, randomised, two-centre trial [J]. Br J Anaesth, 2019, 122(6): 734-741.
[4] Wang G, Li Y, Wu C, et al. The clinical features and related factors of PICC-related upper extremity asymptomatic venous thrombosis in cancer patients: a prospective study [J]. Medicine(Baltimore), 2020, 99(12): e19409.
[5] Rajasekhar A, Streiff MB. How I treat central venous access device-related upper extremity deep vein thrombosis [J]. Blood, 2017, 129(20): 2727-2736.
[6] Baumann Kreuziger L, Onwuemene O, Kolesar E, et al. Systematic review of anticoagulant treatment of catheter-related thrombosis [J]. Thromb Res, 2015, 136(6): 1103-1109.
[7] Streiff MB, Holmstrom B, Ashrani A, et al. Cancer-associated venous thromboembolic disease, version 1.2015 [J]. J Natl Compr Canc Netw, 2015, 13(9): 1079-1095.
[8] Sousa B, Furlanetto J, Hutka M, et al. Central venous access in oncology: ESMO Clinical Practice Guidelines [J]. Ann Oncol, 2015, 26(Suppl 5): 152-168.
[9] Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report [J]. Chest, 2016, 149(2): 315-352.
[10] Hrdy O, Strazevska E, Suk P, et al. Central venous catheter-related thrombosis in intensive care patients-incidence and risk factors: a prospective observational study [J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2017, 161(4): 369-373.
[11] Kahn SR, Elman EA, Bornais C, et al. Post-thrombotic syndrome, functional disability and quality of life after upper extremity deep venous thrombosis in adults [J]. Thromb Haemost, 2005, 93(3): 499-502.
[12] 王丽丽, 王金荣, 高攀, 等. 中心静脉置入设备相关上肢深静脉血栓形成的诊断、预防和治疗[J]. 中国呼吸与危重监护杂志, 2018, 17(5): 532-538. WANG Lili, WANG Jinrong, GAO Pan,et al.Diagnosis, prevention, and treatment of upper extremity deep vein thrombosis related to central venous placement devices [J]. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(5): 532-538.
[13] Rajasekhar A, Streiff MB. Etiology and management of upper-extremity catheter-related thrombosis in cancer patients [J]. Cancer Treat Res, 2019, 179: 117-137. doi: 10.1007/978-3-030-20315-3_8.
[14] Rajasekhar A, Streiff MB. Etiology and management of upper-extremity catheter-related thrombosis in cancer patients [J]. Cancer Treat Res, 2019, 179: 117-137. doi: 10.1007/978-3-030-20315-3_8.
[15] Grant JD, Stevens SM, Woller SC, et al. Diagnosis and management of upper extremity deep-vein thrombosis in adults [J]. Thromb Haemost, 2012, 108(6): 1097-1108.
[16] Verso M, Agnelli G. Venous thromboembolism associated with long-term use of central venous catheters in cancer patients [J]. J Clin Oncol, 2003, 21(19): 3665-3675.
[17] Lee AYY, Kamphuisen PW. Epidemiology and prevention of catheter-related thrombosis in patients with cancer [J]. J Thromb Haemost, 2012, 10(8): 1491-1499.
[18] Thiyagarajah K, Ellingwood L, Endres K, et al. Post-thrombotic syndrome and recurrent thromboembolism in patients with upper extremity deep vein thrombosis: a systematic review and meta-analysis [J]. Thromb Res, 2019, 174: 34-39. doi: 10.1016/j.thromres.2018.12.012.
[19] Laube ES, Mantha S, Samedy P, et al. Treatment of central venous catheter-associated deep venous thrombosis in cancer patients with rivaroxaban [J]. Am J Hematol, 2017, 92(1): E9-E10.
[20] Davies GA, Lazo-Langner A, Gandara E, et al. A prospective study of Rivaroxaban for central venous catheter associated upper extremity deep vein thrombosis in cancer patients(Catheter 2)[J]. Thromb Res, 2018, 162: 88-92. doi: 10.1016/j.thromres.2017.04.003.
[21] Kovacs MJ, Kahn SR, Rodger M, et al. A pilot study of central venous catheter survival in cancer patients using low-molecular-weight heparin(dalteparin)and warfarin without catheter removal for the treatment of upper extremity deep vein thrombosis(The Catheter Study)[J]. J Thromb Haemost, 2007, 5(8): 1650-1653.
[22] Gaddh M, Antun A, Yamada K, et al. Venous access catheter-related thrombosis in patients with cancer [J]. Leuk Lymphoma, 2014, 55(3): 501-508.
[23] Kahn SR, Partsch H, Vedantham S, et al. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization [J]. J Thromb Haemost, 2009, 7(5): 879-883.
[24] Prandoni P, Bernardi E, Marchiori A, et al. The long term clinical course of acute deep vein thrombosis of the arm: prospective cohort study [J]. BMJ, 2004, 329(7464): 484-485.
[25] 刘媛芳, 韦巧玲, 黎容清, 等. 肿瘤患者PICC相关性血栓形成危险因素及风险评估研究进展[J]. 中国医药导报, 2020, 17(28): 52-55. LIU Yuanfang, WEI Qiaoling, LI Rongqing, et al. Research progress on risk factors and assessment of PICC related thrombosis in tumour patients [J]. China Medical Herald, 2020, 17(28): 52-55.
[1] WANG Wei, WANG Yi-Feng, ZHANG Ling-Mei, LIN Qiong-Yan, HUANG Ju. umorigenicity and invasion of side population in human ovarian epithelial cancer OVCAR3 cells [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 8-11.
[2] ZHANG Shi-Bao, LIU Qing-Yong, RUAN Xi-Yun, CHEN Jie, ZHANG Jian-Jun, LI Zong-Wu, YANG Guang-Xiao, WANG Quan-Ying. onstruction and identification of the expression vector of
NT4-SAC-HA2-TAT fusion gene [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 15-19.
[3] LI Bo-Bo, LI Dao-Tang, LIU Shu-Guang, WANG Xing-Wu. Expression of serum DKK-1 in esophageal cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 58-61.
[4] HUANG Fang, KANG Rui, TUN Chun-Lin. Expressions of VEGF-C，nuclear factor-kappa B and  Survivin in nasopharyngeal carcinoma and their clinical implications [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 83-.
[5] XIA Xiaona, HUANG Zhaodi, REN Qingguo, LIU Feng, DENG He, REN Guorong, DUAN Jiandong, WANG Shaoyu. Value of double-phase enhancement CT scan in the differential diagnosis of 182 benign and malignant thyroid nodules [J]. Journal of Shandong University (Health Sciences), 2021, 59(7): 57-62.
[6] NIE Siyue, WANG Zhen, SUN Jingyu, LIU Jie, LI Juan, WEI Xiaojuan, LU Chunxiao, L(¨overU)Xingyan, WANG Shuyun, SUN Yuping. Expression and clinical significance of angiopoietin-like protein 5 in human gastric cancer tissues [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 61-65.
[7] LIU Tong, ZHANG Xin, WANG Chuanxin. Significance of IRX5 mRNA in the diagnosis and prognosis of colorectal cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 69-74.
[8] YU Fei, LIU Shaozhuang, ZHONG Mingwei, HUANG Xin, JIAO Jie, HU Sanyuan, YU Wenbin. Metabolomics analysis of colorectal cancer based on GC-TOF-MS [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 60-68.
[9] XIA Chuanyou, LI Luchao, LI Xiaofeng, YAN Keqiang, ZHANG Nianzhao, FAN Yidong, LIU Cheng. Expression of histone methyltransferase SMYD3 in prostate cancer tissues and its role in mTOR pathway [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 12-16.
[10] ZHANG Zhan, XU Xiangfeng, LIU Haidong, WANG Wei. Diagnostic value of MRI in the T-staging of cervical cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 70-73.
[11] YANG Hui, DONG Rong, XUE Hui, HU Zuquan, ZENG Zhu. Gene microarray analysis of mature dendritic cells cultured with hepatocellular carcinoma cells [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(1): 1-6.
[12] HAO Lijing, GE Shuqing, WANG Shufen, ZHENG Wenjiao, ZHANG Bin. Effects of sorafenib on the proliferation and apoptosis of cisplatin-resistant tongue cancer cells in vitro [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(1): 17-21.
[13] HAN Bo, QI Mei, TAN Weiwei, YANG Muyi. Castration-resistant prostate cancer: current understanding of mechanisms and emerging novel agents [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(9): 1-7.
[14] YU Shaoyi, CHEN Yuanyin, LIU Haiyun, QU Shu'na, XU Ying, WANG Qianqian, WANG Maobo. Burden of malignant neoplasms evaluated by DALYs in Yantai city [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 92-96.
[15] TIAN Xinli, JIAO Jun, ZHANG Teng, MA Daoxin, CUI Baoxia. Expression and significance of Th22 and Th17 cells in the peripheral blood of cervical cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 43-47.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd