Thrombophilia in short peripheral catheter thrombophlebitis

Abstract

Short peripheral catheter thrombophlebitis (SPCT), which is characterized by pain, erythema, swelling, and palpable thrombosis of the cannulated vein, is an important complication of peripheral intravenous catheter use [ [1] Tagalakis V. Kahn S.R. Libman M. Blostein M. (2002) The epidemiology of peripheral vein infusion thrombophlebitis: a critical review. Am J Med. 2003; 113: 146-151 Abstract Full Text Full Text PDF Scopus (189) Google Scholar ]. While the pathogenesis of SPCT is not well understood, one postulated mechanism is that vein wall injury, stasis, and inflammation lead to thrombus formation [ [2] Lewis G.B.H. Hecker J.F. Infusion thrombophlebitis. Br J Anaesth. 1985; 57: 220-233 Crossref PubMed Scopus (99) Google Scholar ]. Catheter-related risk factors for SPCT such as type of catheter material have been well elucidated and are thought to act via vein wall injury. Patient-related risk factors for SPCT are likely to be important as well, as there is evidence that individuals vary in biologic vulnerability to developing SPCT. For example, patients who developed SPCT with a first catheter are 50% more likely to develop SPCT with a subsequent catheter [ [3] Maki D.G. Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Ann Intern Med. 1991; 114: 845-854 Crossref PubMed Scopus (411) Google Scholar ]. However, determinants of patient-related risk factors are largely unknown. To improve understanding of the causes of the biologic vulnerability to SPCT development, we hypothesized that SPCT may be associated with underlying hypercoagulability related to thrombophilia. In recent years, studies have reported associations between thrombophilic disorders, including factor V Leiden, and prothrombin G20210A, and central venous catheter-related thrombosis [ 4 Nowak-Gottl U. Dubbers A. Kececioglu D. Koch H.G. Kotthoff S. Runde J. et al. Factor V Leiden, protein C, and lipoprotein (a) in catheter-related thrombosis in childhood: a prospective study. J Pediatr. 1997; 131: 608-612 Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar , 5 Knofler R. Siegert E. Lauterbach I. Taut-Sack H. Siegert G. Gehrisch S. et al. Clinical importance of prothrombotic risk factors in pediatric patients with malignancy-impact of central venous lines. Eur J Pediatr. 1999; 158: S147-S150 Crossref PubMed Google Scholar , 6 Fijnheer R. Paijmans B. Verdonck L.F. Nieuwenhuis H.K. Roest M. Dekker A.W. Factor V Leiden in central venous catheter-associated thrombosis. Br J Haematol. 2002; 118: 267-270 Crossref PubMed Scopus (64) Google Scholar , 7 Mandalà M. Curigliano G. Bucciarelli P. Ferretti G. Mannucci P.M. Colleoni M. et al. Factor V Leiden and G20210A prothrombin mutation and the risk of subclavian vein thrombosis in patients with breast cancer and a central venous catheter. Ann Oncol. 2004; 15: 590-593 Crossref PubMed Scopus (59) Google Scholar , 8 van Rooden C.J. Rosendaal F.R. Meinders A.E. van Oostayen J.A. van der Meer F.J.M. Huisman M.V. The contribution of factor V Leiden and prothrombin G20210A mutation to risk of central venous catheter-related thrombosis. Haematologica. 2004; 89: 201-206 PubMed Google Scholar , 9 Tesselaar M.E.T. Ouwerkerk J. Nooy M.A. Rosendaal F.R. Osanto S. Risk factors for catheter-related thrombosis in cancer patients. Eur J Cancer. 2004; 40: 2253-2259 Abstract Full Text Full Text PDF PubMed Scopus (92) Google Scholar ]. However, the role of thrombophilia in SPCT has not previously been examined.