Thrombotic complications of tunneled central lines in children with malignancy

J Pediatr Hematol Oncol. 2010 Mar;32(2):88-92. doi: 10.1097/MPH.0b013e3181c09b0c.

Abstract

Background: The total rate of thrombotic complications caused by tunneled central lines (TCL) is still not known, as are the long-term consequences.

Aim of the study: Estimation of a rate of thrombotic complications in children with TCL and malignancy and Doppler ultrasound assessment of blood flow after TCL removal.

Materials and methods: One hundred twenty-four children were enrolled for the study. Heparin lock was used as a prophylaxis for line occlusion. The rate and type of thrombotic events associated with TCL were analyzed in all patients. In children without an earlier history of thrombosis, a Doppler ultrasound examination was carried out after TCL removal.

Results: In 45.2% of patients at least 1 thrombotic event occurred. These events were TCL lumen thrombosis (42.8% of patients) and subclavian vein thrombosis (2.4% of patients). In 37 patients Doppler ultrasound was carried out and revealed an abnormal blood flow in the vein that was examined in 59.5% of them.

Conclusions: The total rate of thrombotic complications in children with TCL and malignancy is high. A substantial proportion of thrombotic complications can be clinically silent. The use of a heparin lock once a week seems far from effective in preventing thrombotic events in patients with TCL. The TCL life span has no influence on the rate of thrombotic events.

MeSH terms

  • Adolescent
  • Asparaginase / adverse effects
  • Catheterization, Central Venous / adverse effects*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Neoplasms / complications
  • Neoplasms / therapy*
  • Thrombosis / etiology*
  • Tissue Plasminogen Activator / therapeutic use
  • Venous Thrombosis / etiology

Substances

  • Tissue Plasminogen Activator
  • Asparaginase