Document Detail

To clot or not to clot? That is the question in central venous catheters.
MedLine Citation:
PMID:  15041454     Owner:  NLM     Status:  MEDLINE    
AIM: To establish the relationship between the tip position of tunnelled central venous catheters (CVC) and the incidence of venous thrombosis. MATERIALS AND METHODS: A randomly sampled, retrospective review of 428 CVC inserted into 334 patients was performed. The chest radiograph obtained post-catheter insertion, as well as follow-up radiographs, linograms, venograms and Doppler ultrasounds (US), were reviewed. RESULTS: The median follow-up was 72 days (range 1-720 days), with a total follow-up of 23,040 line days. Venous thrombosis occurred in five out of 191 (2.6%) CVC in a distal position (distal third of the superior vena cava (SVC) or right atrium (RA)), five of 95 (5.3%) in an intermediate position (middle third of the SVC) and 20 of 48 (41.7%) in a proximal position (proximal third SVC or thoracic inlet veins). There was a significant difference in thrombosis rate between lines sited with the tip in a distal compared with a proximal position (p<0.0005). CVC with tips in a proximal position were 16 times more likely to thrombose than those in a distal position. None of the 58 CVC with the tip located in the RA thrombosed or caused complications. CONCLUSION: Distal placement of tunnelled CVC, either in the distal third of the SVC or proximal RA is optimal.
A Cadman; J A L Lawrance; L Fitzsimmons; A Spencer-Shaw; R Swindell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical radiology     Volume:  59     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-25     Completed Date:  2004-06-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  349-55     Citation Subset:  IM    
University of Manchester Medical School, Manchester, UK.
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MeSH Terms
Catheterization, Central Venous / adverse effects,  methods*
Follow-Up Studies
Middle Aged
Retrospective Studies
Ultrasonography, Doppler
Venous Thrombosis / etiology*,  radiography,  ultrasonography
Comment In:
Clin Radiol. 2004 Sep;59(9):856   [PMID:  15351258 ]
Clin Radiol. 2004 Sep;59(9):855; author reply 857-8   [PMID:  15351257 ]
Clin Radiol. 2004 Sep;59(9):856-7   [PMID:  15351260 ]

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