Abstract Number: OC 69.1
Meeting: ISTH 2021 Congress
Background: Catheter-related arterial thrombosis (CAT) is increasingly recognized in children. No evidence-based guidelines on the diagnosis, treatment and follow-up of pediatric CAT are available.
Aims: To evaluate current practice patterns and gaps in the management of CAT in children.
Methods: REDcap based survey questions were sent to members of the Pediatric/Neonatal Thrombosis and Hemostasis Subcommittee of the International Society on Thrombosis and Haemostasis (ISTH) and the International Pediatric Thrombosis Network (IPTN).
Results: Of the 54 responders completing the survey 49 (91%) are care providers of pediatric hematology/oncology facilities. Of these, 56% treats 1-10, 35% 11-40, and 9% more than 40 CAT cases per year. Doppler ultrasound is the preferred diagnostic modality in 94% and 96% of CAT related to umbilical arterial catheter (UAC) and to extremity indwelling arterial catheter (EIC) or cardiac catheter (CC), respectively. Antithrombotic treatment is usually considered for symptomatic and/or occlusive CAT and consists of unfractionated heparin (UFH) and/or low molecular weight heparin (LMWH) in 98% and 94% of UAC- and EIC/CC-related CAT, respectively. For UAC-related CAT, 15%, 4% and 4% of responders consider switch of initial heparin to acetylsalicylic acid (ASA), vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs), respectively. For EIC/CC-related CAT, a similar switch is considered in 13%, 10%, and 2%, respectively. Treatment duration varies between 3 months in 50%, 6 weeks in 29% and less than 2 weeks in 13% of UAC-related CAT and 3 months in 44%, 6 weeks in 41% and less than 2 weeks in 11% of EIC/CC-related CAT. Long-term follow-up for UAC- and EIC/CC-related CAT is performed by 83% and 67% of responders, respectively.
Conclusions: These data demonstrate that management of pediatric CAT varies considerably. These findings constitute an important rationale for the design of urgently required clinical trials.
To cite this abstract in AMA style:
Rizzi M, Van Ommen CH, Albisetti M, On behalf of the International Pediatric Thrombosis Network (IPTN) . Management Practices of Catheter-related Arterial Thrombosis in Children and Neonates: Results of a Multinational Survey [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/management-practices-of-catheter-related-arterial-thrombosis-in-children-and-neonates-results-of-a-multinational-survey/. Accessed November 26, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/management-practices-of-catheter-related-arterial-thrombosis-in-children-and-neonates-results-of-a-multinational-survey/