Abstract Number: PB1130
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Patients with cancer have a substantially increased risk of venous thromboembolism (VTE) compared with patients without cancer. Long term indwelling central venous catheters (CVC) use has considerably increased to secure vascular access that improve the quality of life. Catheter related upper extremity deep venous thrombosis (CVC-RT) is a common complication. It occurs in approximately 2-6% of cancer patients with a CVC. Studies are needed to define the optimal management of patient with CVC-RT and the risk of recurrence of VTE should be better known.
Aims: To determine the influence of anticoagulation duration on the incidence of recurrent VTE in cancer patients.
Methods: We conducted a retrospective, monocentric observational study at the Amiens-Picardie University Hospital. All consecutive patients with upper extremity thrombosis were included between January 2015 and July 2020. The incidence of thrombosis was estimated using Gray’s method for competitive risk with death as the competitive event. Thrombosis risk factor analysis was performed with the Fine & Gray univariate model for competitive risk with death as the competitive event.
Results:
Mean age was 56 years. 22% had a previous history of VTE. 80% had metastatic status. Mean follow-up was 24 months. 25,5% of patients had reccurence (figure 1), clinical characteristics are detailed in table 1. At reccurence, 41 patients 80,4% still had anticoagulation treatment. In multivariate analysis, previous VTE and maintain of CVC were significant reccurence risk factors. Without CVC, anticoagulant effect had HR=1.05 [1.01 ; 1.09] (p=0.0290). With CVC effect was HR=1.02 [0.99 ; 1.04] (p=0.1890). Anticoagulant treatment effect trends to decrease when CVC is maintained but not significantly (p=0.22).
|
Variable
|
N (%)
|
|
Recurrent VTE, n
During anticoagulation treatment
-EP, n (%)
-DVT of lower limb, n (%)
-CVC-RT, n (%)
CVC status
-Removed, n (%)
-Maintained, n(%)
|
51 (25, 5%)
41 (80,4)
20 (10%)
8 (4%)
30 (15%)
5 (9.8%)
46 (90,2%)
|
Reccurence of venous thrombosis and death
Clinical characteristics of Recurrent VTE
Conclusions: Reccurence of venous thrombosis is frequent after CVC-RT, risk factors are previous VTE and maintain of CVC. Presence of CVC did not influence significantly the risk of reccurence.
To cite this abstract in AMA style:
Hakem R, Soudet S, Sevestre MA. Risk Factors for Reccurence of Catheter Related upper Extremity Deep Venous Thrombosis in Cancer Patients [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/risk-factors-for-reccurence-of-catheter-related-upper-extremity-deep-venous-thrombosis-in-cancer-patients/. Accessed August 16, 2022.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/risk-factors-for-reccurence-of-catheter-related-upper-extremity-deep-venous-thrombosis-in-cancer-patients/