Research progress on peripherally inserted central catheter-related upper extremity venous thrombosis
10.3760/cma.j.cn115822-20220406-00067
- VernacularTitle:经外周静脉置入中心静脉导管相关上肢静脉血栓的研究进展
- Author:
Junren KANG
1
;
Wenyan SUN
Author Information
1. 中国医学科学院 北京协和医学院 临床营养科 100730
- Keywords:
Peripherally inserted central catheter;
Upper extremity vein thrombosis;
Venous thromboembolism
- From:
Chinese Journal of Clinical Nutrition
2022;30(4):249-256
- CountryChina
- Language:Chinese
-
Abstract:
Peripherally inserted central venous catheter (PICC)-related upper extremity venous thrombosis (UEVT) is defined as upper extremity venous thrombosis within the veins where PICCs were placed or adjacent to and may result in pulmonary embolism. Malignancies, previous history of venous thrombosis and malposition are common risk factors for PICC-UEVT. Once patients demonstrate clinical manifestations of phlebitis and thrombosis, such as swelling, pain and tenderness at the PICC site, venous duplex ultrasonography is the first choice for diagnosing PICC-UEVT. According to American College of Chest Physicians guidelines, it's not recommended to remove PICCs upon detection of PICC-UEVT. The first-line treatment is to administer systemic anticoagulants while keeping the catheter in place, unless any contraindications. PICCs could continue to be used during anticoagulation therapy, suppose that catheter tip remains well placed and functions as normal. With early diagnosis and standard anticoagulant treatment, a better clinical outcome could be achieved. Prophylactic anticoagulation is not routinely recommended per guidelines. Recommendation for asymptomatic PICC-related thrombosis is still absent and warrants further prospective studies with large sample size.
