Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer
Journal of Thrombosis and Haemostasis, Volume 11, No. 1, Year 2013
Notification
URL copied to clipboard!
Description
Background:Although long-term indwelling central venous catheters (CVCs) may lead to pulmonary embolism (PE) and loss of the CVC, there is lack of consensus on management of CVC-related thrombosis (CRT) in cancer patients and heterogeneity in clinical practices worldwide. Objectives:To establish common international Good Clinical Practices Guidelines (GCPG) for the management of CRT in cancer patients. Methods:An international working group of experts was set up to develop GCPG according to an evidence-based medicine approach, using the GRADE system. Results:For the treatment of established CRT in cancer patients, we found no prospective randomized studies, two non-randomized prospective studies and one retrospective study examining the efficacy and safety of low-molecular-weight heparin (LMWH) plus vitamin K antagonists (VKAs). One retrospective study evaluated the benefit of CVC removal and two small retrospective studies were on thrombolytic drugs. For the treatment of symptomatic CRT, anticoagulant treatment (AC) is recommended for a minimum of 3months; in this setting, LMWHs are suggested. VKAs can also be used, in the absence of direct comparisons of these two types of anticoagulants in this setting [Guidance]. The CVC can be kept in place if it is functional, well-positioned and non-infected and there is good resolution under close surveillance; whether the CVC is kept or removed, no standard approach in terms of AC duration has been established [Guidance]. For the prophylaxis of CRT in cancer patients, we found six randomized studies investigating the efficacy and safety of VKA vs. placebo or no treatment, one on the efficacy and safety of unfractionnated heparin, six on the value of LMWH, one double-blind randomized and one non randomized study on thrombolytic drugs and six meta-analyses of AC and CVC thromboprophylaxis. Type of catheter (open-ended like the Hickman® catheter vs. closed-ended catheter with a valve like the Groshong® catheter), its position (above, below or at the junction of the superior vena cava and the right atrium) and method of placement may influence the onset of CRT on the basis of six retrospective trials, four prospective non-randomized trials, three randomized trials and one meta-analysis. In light of these data: use of AC for routine prophylaxis of CRT is not recommended [1A]; a CVC should be inserted on the right side, in the jugular vein, and distal extremity of the CVC should be located at the junction of the superior vena cava and the right atrium [1A]. Conclusion:Dissemination and implementation of these international GCPG for the prevention and treatment of CRT in cancer patients at each national level is a major public health priority, needing worldwide collaboration. © 2012 International Society on Thrombosis and Haemostasis.
Authors & Co-Authors
Debourdeau, Philippe M.
France, Marseille
D r s M Centre Médical
Farge, Dominique C.
France, Paris
Hôpital Saint-louis
France, Paris
Université Paris Cité
Beckers, M.
United Kingdom, Cambridge
Cambridge University Hospitals Nhs Foundation Trust
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Baglin, C.
United Kingdom, Cambridge
Cambridge University Hospitals Nhs Foundation Trust
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Bauersachs, Rupert Martin
Germany, Darmstadt
Klinikum Darmstadt
Brenner, Benjamin R.
Unknown Affiliation
Brilhante, D.
Portugal, Lisbon
Instituto Portugues de Oncologia de Francisco Gentil Lisboa
Falanga, Anna
Italy, Bergamo
Ospedali Riuniti Di Bergamo
Gerotzafias, G. T.
France, Paris
Ap-hp Assistance Publique - Hopitaux de Paris
Haim, Nissim
Israel, Haifa
Division of Oncology
Kakkar, Ajay K.
United Kingdom, London
Queen Mary University of London
Khorana, Alok A.
United States, Rochester
University of Rochester Medical Center
Lecumberri, Ramón
Spain, Pamplona
Clinica Universitaria de Navarra
Mandala, M.
Italy, Bergamo
Ospedali Riuniti Di Bergamo
Marty, Michael E.
France, Paris
Hôpital Saint-louis
Monreal, M.
Spain, Badalona
Hospital Universitari Germans Trias I Pujol
United States, Albany
Albany College of Pharmacy and Health Sciences
Mousa, Shaker A.
Saudi Arabia, Riyadh
King Saud University
Noble, Simon
United Kingdom, Cardiff
Cardiff University
Pabinger, Ingrid
Austria, Vienna
Medizinische Universität Wien
Prandoni, Paolo P.
Italy, Padua
Università Degli Studi Di Padova
Prins, Martin H.
Netherlands, Maastricht
Universiteit Maastricht
Qari, Mohamad Hasan
Saudi Arabia, Jeddah
King Abdulaziz University
Streiff, Michael B.
United States, Baltimore
Johns Hopkins School of Medicine
Syrigos, Kostas
Greece, Athens
Sotiria General Hospital
Büller, Harry R.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Bounameaux, Henri Ruti
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Statistics
Citations: 275
Authors: 26
Affiliations: 25
Identifiers
Doi:
10.1111/jth.12071
ISSN:
15387933
e-ISSN:
15387836
Research Areas
Cancer
Disability
Genetics And Genomics
Health System And Policy
Study Design
Cohort Study
Quasi Experimental Study
Study Approach
Systematic review