Annals for Hospitalists Inpatient Notes - How I Treat—Catheter-Related Deep Venous Thrombosis

Web Exclusives21 May 2019Annals for Hospitalists Inpatient Notes - How I Treat—Catheter-Related Deep Venous ThrombosisVineet Chopra, MD, MScVineet Chopra, MD, MScUniversity of Michigan Health System and Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan (V.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1172 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail With growing use of peripherally inserted central catheters (PICCs), upper-extremity deep venous thrombosis (DVT) is becoming more common. In a study of hospitalized medical patients, upper-extremity DVT accounted for half of all hospital-onset cases and most of these events were associated with PICCs (1). In a systematic review and meta-analysis, these catheters were found to be associated with a 2.5-fold risk for thrombosis compared with other central venous catheters. Of note, risk for DVT with PICCs was greater in patients with cancer and those with critical illness (2). Because hospitalists often care for and treat patients with PICCs and because ...References1. Winters JP, Callas PW, Cushman M, Repp AB, Zakai NA. Central venous catheters and upper extremity deep vein thrombosis in medical inpatients: the Medical Inpatients and Thrombosis (MITH) Study. J Thromb Haemost. 2015;13:2155-60. [PMID: 26340226] doi:10.1111/jth.13131 CrossrefMedlineGoogle Scholar2. Chopra V, Anand S, Hickner A, Buist M, Rogers MA, Saint S, et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet. 2013;382:311-25. [PMID: 23697825] doi:10.1016/S0140-6736(13)60592-9 CrossrefMedlineGoogle Scholar3. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149:315-352. [PMID: 26867832] doi:10.1016/j.chest.2015.11.026 CrossrefMedlineGoogle Scholar4. Davies GA, Lazo-Langner A, Gandara E, Rodger M, Tagalakis V, Louzada M, et al. A prospective study of Rivaroxaban for central venous catheter associated upper extremity deep vein thrombosis in cancer patients (Catheter 2). Thromb Res. 2018;162:88-92. [PMID: 28416213] doi:10.1016/j.thromres.2017.04.003 CrossrefMedlineGoogle Scholar5. Shi Y, Shi W, Chen L, Gu J. A systematic review of ultrasound-accelerated catheter-directed thrombolysis in the treatment of deep vein thrombosis. J Thromb Thrombolysis. 2018;45:440-451. [PMID: 29417407] doi:10.1007/s11239-018-1629-y CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan Health System and Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan (V.C.)Grant Support: From the Agency for Healthcare Research and Quality.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1172.Corresponding Author: Vineet Chopra, MD, MSc, Division of Hospital Medicine, University of Michigan Health System, 2800 Plymouth Road, Building 16, #432W, Ann Arbor, MI 48109; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 21 May 2019 David H. Wesorick and Vineet Chopra Metrics 21 May 2019Volume 170, Issue 10Page: HO2-HO3KeywordsCathetersDeep vein thrombosisDisclosureHemorrhageHospitalistsPeripherally inserted central cathetersSystematic reviewsThoraxThrombosisVeins ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...