METHODS: From a retrospective review of medical records, we identified 13 patients with various gynecologic
malignancies who were diagnosed with UEDVT during their disease course. We obtained
tumor data, detailed information regarding the
indwelling catheters used, and the diagnosis and management of UEDVT.
RESULTS: Two hundred sixty-four women with gynecologic
malignancies underwent insertion of an indwelling peripheral
catheter by interventional radiology over a 5-year period. A total of 325
catheters were placed in these patients. Thirteen patients developed UEDVTs, and all had a
catheter in situ at the time of DVT diagnosis. Eleven of thirteen patients had Peripheral Access System (PAS) Ports and two had peripheral indwelling central
catheters (PICCs). The mean age of the patients was 53 years (range, 32-70). At the time of UEDVT diagnosis patients had the following: progressive
cancer (n = 8), stable disease (n = 1), no evaluable disease (n = 4), and actively receiving
chemotherapy (n = 7). Clinical signs/symptoms at the time of diagnosis included:
catheter occlusion (n = 2), arm swelling and
pain (n = 10), and
superior vena cava syndrome (n = 1). Diagnosis of
thrombosis was confirmed using Doppler ultrasound (n = 4), venography (n = 5), and both modalities (n = 4). Management of UEDVT consisted of anticoagulation with
warfarin (2-6 months) (n = 9),
urokinase infusion (n = 2), intravenous
antibiotics for 21 days and
heparin for 10 days (n = 1), arm elevation only (n = 1),
Lovenox for 60 days (n = 1), and no
therapy (n = 1). There were no complications associated with anticoagulation. No patient had a
pulmonary embolism. The incidence of UEDVT among our patients with indwelling venous
catheters was 5.7%.
CONCLUSION: