Primary thromboprophylaxis for cancer patients with central venous catheters--a reappraisal of the evidence.
Catheterization, Central Venous
Clinical Trials as Topic
MetadataShow full item record
CitationPrimary thromboprophylaxis for cancer patients with central venous catheters--a reappraisal of the evidence. 2006, 94 (2):189-94 Br. J. Cancer
JournalBritish journal of cancer
AbstractVenous thromboembolism (VTE) is responsible for an estimated 25 000 deaths per annum in UK hospital practice. It is well established that many of these deaths could be prevented through the use of appropriate thromboprophylaxis. This issue is of particular relevance in oncology practice, where the risks of VTE and bleeding are both significantly higher than those observed in general medical patients. Cancer patients with in-dwelling central venous catheters (CVCs) are at particularly high risk of developing thrombotic complications. However, the literature has produced conflicting conclusions regarding the efficacy of using routine primary thromboprophylaxis in these patients. Indeed such is the level of confusion around this topic, that the most recent version of the American College of Chest Physicians (ACCP) guidelines published in 2004 actually reversed their previous recommendation (published in 2001). Nevertheless, minidose warfarin continues to be routinely used in many oncology centres in the UK. In this article, we have performed a systematic review of the published literature regarding the efficacy and the risks, associated with using thromboprophylaxis (either minidose warfarin or low-dose LMWH) in cancer patients with CVC. On the basis of this evidence, we conclude that there is no proven role for using such thromboprophylaxis. However, asymptomatic CVC-related venous thrombosis remains common, and further more highly powered studies of better design are needed in order to define whether specific subgroups of cancer patients might benefit from receiving thromboprophylaxis.
- Systemic anticoagulant prophylaxis for central catheter-associated venous thrombosis in cancer patients.
- Authors: Chan A, Iannucci A, Dager WE
- Issue date: 2007 Apr
- Prophylaxis of catheter-related venous thrombosis in cancer patients.
- Authors: Karthaus M
- Issue date: 2008 Jul
- Warfarin thromboprophylaxis in cancer patients with central venous catheters (WARP): an open-label randomised trial.
- Authors: Young AM, Billingham LJ, Begum G, Kerr DJ, Hughes AI, Rea DW, Shepherd S, Stanley A, Sweeney A, Wilde J, Wheatley K, WARP Collaborative Group, UK.
- Issue date: 2009 Feb 14
- Thrombotic complications of central venous catheters in cancer patients.
- Authors: Kuter DJ
- Issue date: 2004
- Thromboprophylaxis for catheter-related thrombosis in patients with cancer: a systematic review of the randomized, controlled trials.
- Authors: Carrier M, Tay J, Fergusson D, Wells PS
- Issue date: 2007 Dec