Abstract Number: PB2143
Meeting: ISTH 2020 Congress
Background: Catheter-related upper extremities deep vein thrombosis (UEDVT) represents a major issue for cancer patients. Consensus opinion for the treatment of catheter-related UEDVT in cancer patients is still not completely defined.
Aims: To describe a single-center clinical casistic of cancer patients with catheter-related UEDVT and to determine rate of VTE recurrences in patients undergoing a short-course (3 months) versus a longer course of anticoagulant therapy.
Methods: Retrospective study. Enrollment of consecutive patients with active cancer and catheter-related UEDVT from Cardiovascular Medicine database from August 2016 to August 2018. Diagnosis of catheter-related UEDVT obtained by compression ultrasonography. Minimum follow up of 6 months up, maximum of 24 months. Individualized duration of therapy was established by the vascular medicine specialist.
Results: A total of 84 patients with cancer and catheter-related UEDVT were enrolled. The most common device were PICC (75%) and Port-a-cath (16,3%). Types of cancer varied from solid tumors (breast 19%, colorectal 10.7%, lung 7.1%) to hematologic malignancies (lymphomas 23.8%). 29 patients (34.5%) died within 2 years of follow-up. Cancer represented the first cause of death (72.4%) followed by sepsis (11%), hemorrhagic events (7.4%) and fatal pulmonary embolism (3.4%). Total rate of VTE recurrences was 22.2% in patients undergoing ≤ 3 months anticoagulation and 20.8% in longer therapies; deaths were 36% versus 33% (p>0.05). On the opposite, total hemorrhagic events were more frequent in the first group (16.7% versus 6.4%), despite the short term of therapy, in relation to the more frequent critical thrombocytopenia
Conclusions: Present data are in line with previous studies. Recurrent thrombotic risk wasn’t negligible independently from anticoagulant duration. Hemorrhagic rates in the second group were related to high individual hemorrhagic risk rather than duration of anticoagulation. Our results suggest that a defined duration of anticoagulant therapy can’t be generally established, therefore personalized approaches must be considered.
To cite this abstract in AMA style:Dalla Salda A, Spaggiari E, Abbate B, Iotti M, Depietri L, Corradini S, Lambertini I, Veropalumbo MR, Ghirarduzzi A. Catheter-Associated Upper Extremities Deep Vein Thrombosis in Cancer Patients: Does Anticoagulation Time Matter? [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/catheter-associated-upper-extremities-deep-vein-thrombosis-in-cancer-patients-does-anticoagulation-time-matter/. Accessed September 29, 2023.
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