Abstract
Insertion of peripherally inserted central catheters in oncological patients is potentially associated with catheter-related thrombosis and fibroblastic sleeve; the actual incidence and interactions between these two non-infective complications have never been investigated in a prospective clinical study on peripherally inserted central catheters. In a cohort of oncological/hematological patients with peripherally inserted central catheter, we evaluated the occurrence of catheter-related thrombosis and/or fibroblastic sleeve, examining all patients by ultrasound scan at days 7, 14, 21, and 28 after insertion. We correlated our findings with the type of disease. We enrolled 254 patients with power injectable polyurethane 4Fr peripherally inserted central catheters. Ultrasound scan of the veins of the arm showed fibroblastic sleeve in 76 patients (29.9%); the fibroblastic sleeve was first detected on day 7 in 45 cases (17.7%), on day 14 in 26 cases (10.2%), on day 21 in 3 cases (1.2%), and on day 28 in 2 cases (0.79%). There was no correlation between the type of disease and the development of fibroblastic sleeve. The incidence of asymptomatic catheter-related thrombosis was 5.12%: all catheter-related thromboses were detected before day 14. There was only one case of symptomatic catheter-related thrombosis (0.39%) in a leukemia patient. Fibroblastic sleeve and catheter-related thrombosis were associated only in two cases (0.78%). Fibroblastic sleeve is a frequent (29.9%) but asymptomatic finding in oncological and hematological patients with peripherally inserted central catheter, and-in the vast majority of cases-it occurs within 2 weeks after insertion. If compared to fibroblastic sleeve, asymptomatic catheter-related thrombosis is less frequent (5.51%); symptomatic catheter-related thrombosis is rare (<1%).
Published Version
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