Thrombus and thrombosis in cancer patients with permanent venous catheters

Summary

Cancer patients have additive risk factors for thrombosis especially if permanent central catheters (port systems) are used for the delivery of chemotherapy. In our hospital the rate of thrombotic complications is below 5% for cancer patients receiving chemotherapy via port systems. This is in contrast to clinical studies, which have shown that up to 60% of catheters acquire clots that obstruct more than 50% of the vascular lumen. It is reasonable to believe that complications arising from thrombotic catheter alterations, such as bacterial hosting or micro-emboli, are clinically underestimated. The identification of thrombotic alterations of permanent central venous catheters in cancer patients receiving chemotherapy is substantial for the estimation whether anticoagulation strategies should be used as prophylaxis.

Zusammenfassung

Patienten mit malignen Tumoren haben additive thrombogene Risikofaktoren. Dies gilt insbesondere dann, wenn eine vasotoxische Chemotherapie über einen permanenten zentralen Zugang (Port-System) appliziert wird. Nach unserer Erfahrung sind klinisch apparente Komplikationen der Port-Systeme selten und liegen unter 5%. Demgegenüber finden sich bei präklinischen Untersuchungen in einem Prozentsatz von bis zu 60% thrombotische Veränderungen des Kathetersystems. Es ist anzunehmen, dass Komplikationen, bedingt durch diese thrombotischen Veränderungen, wie z.B. bakterielle Besiedelung und Mikroembolien, klinisch unterschätzt werden. Die Diagnose thrombotischer Veränderungen bei Tumorpatienten, die ihre Chemotherapie über ein Portsystem bekommen, ist eine Voraussetzung, um prophylaktische Behandlungen, z.B. mit niedermolekularen Heparinen, in Erwägung zu ziehen.

Keywords

Chemotherapy - thrombus - thrombosis - anticoagulation

Schlüsselwörter

Chemotherapie - Thrombus - Thrombose - Antikoagulation

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