A pilot study of central venous catheter survival in cancer patients using low-molecular-weight heparin (dalteparin) and warfarin without catheter removal for the treatment of upper extremity deep vein thrombosis (The Catheter Study).

Abstract

BACKGROUND:

Central venous catheters in patients with cancer are associated with development of deep vein thrombosis (DVT); however, there is no accepted standard treatment.

OBJECTIVES:

To assess the safety and effectiveness of a management strategy for central venous catheter-related DVT in cancer patients consisting of dalteparin and warfarin without the need for line removal.

PATIENTS/METHODS:

Patients older than 18 years of age with an active malignancy and who had symptomatic, acute, objectively documented UEDVT were eligible. Patients were treated with dalteparin 200 IU kg(-1) per day for 5-7 days and warfarin with a target International Normalized Ratio of 2.0-3.0. Patients were followed for 3 months for recurrent venous thromboembolism, major hemorrhage and survival of the central venous catheter.

RESULTS:

There were 74 patients (48 males). The average age was 58 years. There were no episodes of recurrent venous thromboembolism and three (4%) major bleeds. No lines were removed because of infusion failure or recurrence/extension of DVT.

CONCLUSION:

Treatment of UEDVTs secondary to central catheters in cancer patients with standard dalteparin/warfarin can allow the central line to remain in situ with little risk of line failure or recurrence/extension of the DVT.

• Authors: M J Kovacs, S R Kahn, M Rodger, D R Anderson, R Andreou, J E Mangel, B Morrow, A M Clement, P S Wells
• Journal: Journal of thrombosis and haemostasis : JTH (J Thromb Haemost) Vol. 5 Issue 8 Pg. 1650-3 (Aug 2007) ISSN: 1538-7933 [Print] England
• PMID: 17488349 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anticoagulants
• Warfarin
• Dalteparin

Topics

• Aged
• Anticoagulants (administration & dosage)
• Catheterization, Central Venous (methods)
• Cohort Studies
• Dalteparin (administration & dosage)
• Female
• Humans
• International Normalized Ratio
• Male
• Middle Aged
• Neoplasms (complications, drug therapy)
• Pilot Projects
• Treatment Outcome
• Venous Thrombosis (complications, drug therapy)
• Warfarin (administration & dosage)