Central venous catheters (CVC) are important for the infusion of
chemotherapy, intravenous medications, and blood products. Catheter-related
thrombosis (CRT) is common among cancer patients. The lower rates of CRT underreported as many are asymptomatic. Many patient-related factors such as age, venous
anatomy, tumor characteristics (histology, size, and location, and catheter-specific
features) have been attributed to CRT. Also, limitations of the diagnostic criteria exist.
Doppler ultrasound is the common initial test but can be non-diagnostic. Contrast
venography is the ‘gold standard’ and considered once Doppler negative but with
strong clinical suspicion. Newer diagnostic tools such as contrast CT or MRI has
emerged as promising alternatives but with occasional use. Anticoagulation is the
treatment of choice once DVT is confirmed but there are no established standard
guidelines. The catheter should be preserved with low molecular weight heparin for a
minimum of three months. No anticoagulants are advised for routine prophylaxis but
can be considered in high-risk groups.
Keywords: Cancer-associated thrombosis, Catheter-directed local thrombolysis,
Catheter-related thrombosis (CRT), Chemotherapy, Contrast venography, CRT,
CVC-related infection, DVT treatment, Intraluminal clot, LMWH in catheterrelated thrombosis, Mural thrombus, Port associated thrombosis, Thrombosis in
malignancy, WARP study.
