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Matsunaga T, Kita H, Naito K, Morimoto M, Nakanishi K. Treatment of Catheter-Associated Internal Jugular Vein Thrombosis Using Apixaban for Less Than Three Months in Two Patients With Aggressive B-cell Lymphoma Undergoing Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone Therapy. Cureus 2024; 16:e58528. [PMID: 38644952 PMCID: PMC11027025 DOI: 10.7759/cureus.58528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 04/23/2024] Open
Abstract
The selection of anticoagulant therapy and appropriate duration of treatment for central venous (CV) catheter-associated internal jugular vein thrombosis in patients with malignant lymphoma remain unclear. Two cases of aggressive B-cell lymphomas treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), in which apixaban administered for less than three months was effective against CV catheter-associated internal jugular vein thrombosis, are reported. In one case, the right internal jugular vein thrombosis developed after eight courses of R-CHOP; when apixaban was orally administered for 37 days after the CV catheter was removed, the thrombus completely dissolved and did not recur for 27 months. In the other case, right internal jugular vein thrombosis developed after four courses of R-CHOP; two additional courses of the R-CHOP were administered alongside oral apixaban administration without catheter removal. After 66 days of oral apixaban, the thrombus completely dissolved, the CV catheter was removed, and no recurrence was observed for 8.5 months.
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Affiliation(s)
- Takuya Matsunaga
- Department of Hematology, Japan Community Health Care Organization (JCHO) Sapporo Hokushin Hospital, Sapporo, JPN
| | - Hiroyuki Kita
- Department of Cardiology, Japan Community Health Care Organization (JCHO) Sapporo Hokushin Hospital, Sapporo, JPN
| | - Kazuyuki Naito
- Department of Cardiology, Sapporo Central Hospital, Sapporo, JPN
| | - Masako Morimoto
- Department of Pharmaceuticals, Japan Community Health Care Organization (JCHO) Sapporo Hokushin Hospital, Sapporo, JPN
| | - Katsuya Nakanishi
- Department of Pathology, Japan Community Health Care Organization (JCHO) Sapporo Hokushin Hospital, Sapporo, JPN
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Brgdar A, Ojo AS, Rougui L, Anee K, Sumon M, Mehari A. Pulmonary Embolism and Chronic Superior Vena Cava Occlusion Complicating Central Line-Associated Venous Thromboembolism in a Sickle Cell Disease Patient. Cureus 2022; 14:e22113. [PMID: 35308691 PMCID: PMC8918275 DOI: 10.7759/cureus.22113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 12/05/2022] Open
Abstract
Sickle cell disease (SCD), the most common genetic disorder globally, is often associated with an increased risk of venous thromboembolic events (VTE). Many of these patients have central lines placed for the purposes of repeated medication administration, blood transfusions, and blood draw, further increasing the risk of VTE. Given the non-specific presentation of VTE and pulmonary embolism, as well as the risk of mortality if interventions are delayed, a high index of suspicion is required for early diagnosis of the condition. We report the case of a 35-year-old woman with SCD and a port-a-cath in place who presented with extensive upper extremity and intrathoracic VTE with associated pulmonary embolism and chronic superior vena cava (SVC) occlusion. We also discuss the peculiarities of the clinical manifestations and management of VTE and pulmonary embolism in the setting of SCD based on the evidence from existing literature.
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Chennakeshavallu GN, Sankar S, Ponnaboyina S. Incidental Intraoperative Detection of Central Venous Catheter-related Internal Jugular Vein Thrombus in an Infant with d-Transposition of Great Arteries. J Med Ultrasound 2021; 29:296-297. [PMID: 35127414 PMCID: PMC8772474 DOI: 10.4103/jmu.jmu_128_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/17/2020] [Accepted: 10/21/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- G N Chennakeshavallu
- Division of Cardiac Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sruthi Sankar
- Division of Cardiac Anesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sirish Ponnaboyina
- Division of Cardiac Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Premuzic V, Mihaljevic D, Pasini M, Mesar I, Luetic T, Antabak A. Durability of tunneled catheters in children is associated with catheter tip depth: A single-center report. Ther Apher Dial 2020; 25:490-496. [PMID: 33026706 DOI: 10.1111/1744-9987.13593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/21/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the impact of different catheter tip positions on catheter duration and dysfunction of tunneled catheters in children. Catheters were evaluated for place of insertion, time of insertion, catheter tip depth and position, duration of use, and reason for removal. The mean duration of implanted catheters with tips placed in cavo-atrial junction/right atrium was significantly longer with significantly lower percentage of complications than tips placed in superior vena cava. Only catheter tips placed in cavo-atrial junction/right atrium was a predictor of catheter functionality and survival. Shorter catheter survival in children with tunneled catheters is a consequence of a catheter tip depth proximal of CAJ and RA. Our results showed that the main factor responsible for better catheter functionality was not laterality but the depth of the catheter tip, which reduces need for future catheter insertions with increased catheter durability.
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Affiliation(s)
- Vedran Premuzic
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dragan Mihaljevic
- Anesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miram Pasini
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ines Mesar
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Luetic
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Anko Antabak
- Pediatric Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
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Drakos P, Ford BC, Labropoulos N. A systematic review on internal jugular vein thrombosis and pulmonary embolism. J Vasc Surg Venous Lymphat Disord 2020; 8:662-666. [DOI: 10.1016/j.jvsv.2020.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/09/2020] [Indexed: 11/26/2022]
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Schears GJ, Ferko N, Syed I, Arpino JM, Alsbrooks K. Peripherally inserted central catheters inserted with current best practices have low deep vein thrombosis and central line–associated bloodstream infection risk compared with centrally inserted central catheters: A contemporary meta-analysis. J Vasc Access 2020; 22:9-25. [DOI: 10.1177/1129729820916113] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Peripherally inserted central catheters and centrally inserted central catheters have numerous benefits but can be associated with risks. This meta-analysis compared central catheters for relevant clinical outcomes using recent studies more likely to coincide with practice guidelines. Methods: Several databases, Ovid MEDLINE, Embase, and EBM Reviews were searched for articles (2006–2018) that compared central catheters. Analyses were limited to peer-reviewed studies comparing peripherally inserted central catheters to centrally inserted central catheters for deep vein thrombosis and/or central line–associated bloodstream infections. Subgroup, sensitivity analyses, and patient-reported measures were included. Risk ratios, incidence rate ratios, and weighted event risks were reported. Study quality assessment was conducted using Newcastle–Ottawa and Cochrane Risk of Bias scales. Results: Of 4609 screened abstracts, 31 studies were included in these meta-analyses. Across studies, peripherally inserted central catheters were protective for central line–associated bloodstream infection (incidence rate ratio = 0.52, 95% confidence interval: 0.30–0.92), with consistent results across subgroups. Peripherally inserted central catheters were associated with an increased risk of deep vein thrombosis (risk ratio = 2.08, 95% confidence interval: 1.47–2.94); however, smaller diameter and single-lumen peripherally inserted central catheters were no longer associated with increased risk. The absolute risk of deep vein thrombosis was calculated to 2.3% and 3.9% for smaller diameter peripherally inserted central catheters and centrally inserted central catheters, respectively. On average, peripherally inserted central catheter patients had 11.6 more catheter days than centrally inserted central catheter patients ( p = 0.064). Patient outcomes favored peripherally inserted central catheters. Conclusion: When adhering to best practices, this study demonstrated that concerns related to peripherally inserted central catheters and deep vein thrombosis risk are minimized. Dramatic changes to clinical practice over the last 10 years have helped to address past issues with central catheters and complication risk. Given the lower rate of complications when following current guidelines, clinicians should prioritize central line choice based on patient therapeutic needs, rather than fear of complications. Future research should continue to consider contemporary literature over antiquated data, such that it recognizes the implications of best practices in modern central catheterization.
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Affiliation(s)
| | - Nicole Ferko
- Cornerstone Research Group Inc., Burlington, ON, Canada
| | - Imran Syed
- Cornerstone Research Group Inc., Burlington, ON, Canada
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Kara H. Internal Jugular Vein Thrombosis due to Chronic Kidney Disease: A Case Report. Ann Vasc Surg 2019; 62:500.e1-500.e3. [PMID: 31560940 DOI: 10.1016/j.avsg.2019.08.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/02/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
Internal jugular vein (IJV) thrombosis is a rare vascular event. The most common causes of internal jugular vein thrombosis are prolonged central venous catheterization, infection, malignancy and ovarian hyperstimulation syndrome. We have presented here a case of an 82-year-old male with chronic kidney disease who presented with left neck swelling and pain who was found to have a thrombus in the left IJV. He was successfully treated with conservative treatment without any complications.
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Affiliation(s)
- Hakan Kara
- Department of Cardiovascular Surgery, Giresun Ada Hospital, Giresun, Turkey.
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Policastro LJ, Koci K. Iatrogenic Paradoxical Stroke in a Patient With Catheter-Associated Thrombosis and Systemic-to-Pulmonary Venous Shunt. J Investig Med High Impact Case Rep 2018; 6:2324709618813175. [PMID: 30480004 PMCID: PMC6243407 DOI: 10.1177/2324709618813175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/15/2018] [Accepted: 10/20/2018] [Indexed: 11/17/2022] Open
Abstract
Paradoxical embolism occurs when thrombotic material traverses a right-to-left shunt. We describe the first case of paradoxical stroke resulting from manipulation of a disused chemotherapy port. Contrast studies revealed that the mechanism was systemic-to-pulmonary venous shunt, in which systemic veins drain into the left atrium via collaterals. Chronically thrombosed central venous catheters may result in venous stenosis and shunt formation, exposing patients to risks of paradoxical stroke, acute coronary syndrome, hypoxemia, and other complications. This case highlights the life-threatening complications that may result from neglect of an implantable central venous catheter. Preventative measures are to promptly recognize and treat catheter-related thrombosis and to remove unneeded catheters.
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Affiliation(s)
| | - Kristaq Koci
- SUNY Downstate Medical Center, Brooklyn, NY, USA
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Premuzic V, Perkov D, Smiljanic R. The development of central venous thrombosis in hemodialyzed patients is associated with catheter tip depth and localization. Hemodial Int 2018; 22:454-462. [PMID: 29722112 DOI: 10.1111/hdi.12662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of our work was to analyze the incidence of tunneled hemodialysis catheters-related thrombosis in hemodialyzed patients depending on catheter tip depth and position and to evaluate the impact of other established risk factors responsible for development of central venous thrombosis. METHODS The presence of central vein thrombosis, location, and the depth of the catheter tip was reviewed by two experienced radiologists. All patients with suspected central venous thrombosis had factor V Leiden, lupus anticoagulant, and cardiolipin antibodies checked (acIgM and acIgG) and were evaluated with cat-scan venography. FINDINGS A total of 68 tunneled hemodialysis catheters were analyzed with CT venography for central venous thrombosis. There were no signs of central venous thrombosis when catheter tips were placed in the right atrium. There was significantly higher number of catheter tips located on the vein wall than located centrally in patients with central venous thrombosis. Higher percentage of central venous thrombosis, smaller number of tips placed in the right atrium, higher values of IgM cardiolipin antibodies, and higher number of patients with positive factor V Leiden mutation were found in group of patients with catheter tips located on vein wall. DISCUSSION Higher incidence of central venous thrombosis in patients with the catheter tip placed on the vein wall is a consequence of a catheter tip depth proximal of the right atrium. Increased factor V Leiden mutation and acIgM values in these patients should be observed as a result of the vein stasis caused by inappropriate catheter tip depth and localization.
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Affiliation(s)
- Vedran Premuzic
- Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Drazen Perkov
- Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ranko Smiljanic
- Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
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Li W, Li F, Wang H, Long X, Ghimire O, Pei Y, Xiao X, Ning J. Thrombotic complications and tip position of transjugular chronic dialysis catheter scheduled into superior vena cava: Findings on HR-MRCP and HR-T2WI. Medicine (Baltimore) 2017; 96:e7135. [PMID: 28658104 PMCID: PMC5500026 DOI: 10.1097/md.0000000000007135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Catheter-related thrombotic complications(TCs) can occur during the long term use of a chronic dialysis catheter (CDC), including fibrin sheath (FS), mural thrombosis (MT), venous thrombosis (VT), and intraluminal clots (IC), which has not been reported with MRI. The aim of our study was to evaluate the determination of catheter tip position (TP) and resolution of TCs in patients with transjugular CDC scheduled into the superior vena cava using high resolution magnetic resonance cholangiopancreatography (HR-MRCP) and T2-weighted imaging (HR-T2WI). METHODS The study protocol was approved by the local Research Ethics Committee. Informed consent was obtained from all patients. In total, 41 consecutively enrolled transjugular CDC patients with suspected catheter dysfunction were scanned with HRMRCP and HR-T2WI. The distance from the top to the tip of the catheter and the presence and nature of catheter TCs were assessed by 2 experienced radiologists. Chest x-ray was taken within 1 to 2 days and CDC was withdrawn within 3 to 10 days from those patients with TCs identified by HR-MRI. RESULTS A total of 38 subjects successfully underwent HR-MRI, including 13 normal and 25 with TCs (fibrin sheath [FS]: n = 21, mural thrombosis [MT]: n = 7, venous thrombosis [VT]: n = 3, intraluminal clots [IC]: n = 4). There was no significant difference between HR-MRCP and chest x-ray in catheter TP determination (P = .124). Normal catheter appeared as "double eyes" on HR-T2WI and "double tracks" on HR-MRCP. TCs appeared as follows: FS displayed as a "thin ring" (<1mm) around the catheter, MT as patchy hyperintensity and VT as a "thick ring" (>5mm) on HR-T2WI. Unilateral IC appeared as a "single eye" on HR-T2WI and a "single track" on HR-MRCP (n = 3). Bilateral IC appeared as neither "eye" nor "track" (n = 1). Catheter withdrawal confirmed FS (n = 16), MT (n = 6), VT (n = 1), and IC (n = 4). CONCLUSION HR-MRCP and HR-T2WI are promising methods for visualizing TP and TCs in CDC patients, and are helpful in adjusting the treatment plan and avoiding the risk of pulmonary embolism.
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Affiliation(s)
- Whenzheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha
| | - Fang Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha
| | - He Wang
- Philips Healthcare, Buiding, Shanghai
| | - Xueying Long
- Department of Radiology, Xiangya Hospital, Central South University, Changsha
| | - Obin Ghimire
- Department of Radiology, Xiangya Hospital, Central South University, Changsha
| | - Yigang Pei
- Department of Radiology, Xiangya Hospital, Central South University, Changsha
| | - Xiangcheng Xiao
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, China
| | - Jianping Ning
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, China
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Newton DH, Monreal Bosch M, Amendola M, Wolfe L, Perez Ductor C, Lecumberri R, Levy MM, Monreal M, Decousus H, Prandoni P, Brenner B, Barba R, Di Micco P, Bertoletti L, Tzoran I, Reis A, Bosevski M, Bounameaux H, Malý R, Wells P, Papadakis M, Agüero R, Aibar M, Alfonso M, Aranda R, Arcelus J, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Binetti J, Blanco-Molina A, Bueso T, Cañas I, Carmona F, Chic N, Culla A, del Pozo R, del Toro J, Díaz-Pedroche M, Díaz-Peromingo J, Falgá C, Fernández-Aracil C, Fernández-Capitán C, Fidalgo M, Font C, Font L, Gallego P, García M, García-Bragado F, Gómez V, González J, Grau E, Grimón A, Guirado L, Gutiérrez J, Hernández-Comes G, Hernández-Blasco L, Jara-Palomares L, Jaras M, Jiménez D, Joya M, Lecumberri R, Lobo J, López-Jiménez L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Manrique-Abos I, Marchena P, Martín M, Martín-Antorán J, Martín-Martos F, Monreal M, Nieto J, Nieto S, Núñez A, Núñez M, Otalora S, Otero R, Pagán B, Pedrajas J, Pérez G, Pérez I, Pérez-Ductor C, Peris M, Porras J, Reig O, Riera-Mestre A, Riesco D, Rivas A, Rodríguez-Dávila M, Rosa V, Rosillo-Hernández E, Ruiz-Artacho P, Ruiz-Giménez N, Sahuquillo J, Sala-Sainz M, Sampériz A, Sánchez R, Sanz O, Soler S, Sopeña B, Suriñach J, Tolosa C, Trujillo-Santos J, Uresandi F, Valero B, Valle R, Vela J, Vidal G, Villalta J, Vanassche T, Verhamme P, Wells P, Hirmerova J, Malý R, Salgado E, Bertoletti L, Bura-Riviere A, Champion K, Farge-Bancel D, Hij A, Mahé I, Merah A, Papadakis M, Braester A, Brenner B, Tzoran I, Antonucci G, Barillari G, Bilora F, Ciammaichella M, Dentali F, Di Micco P, Duce R, Ferrazzi P, Grandone E, Lodigiani C, Maida R, Pace F, Pesavento R, Poggio R, Prandoni P, Rota L, Tiraferri E, Tonello D, Tufano A, Visonà A, Zalunardo B, Drucka E, Kigitovica D, Skride A, Ramos A, Ribeiro J, Sousa M, Bosevski M, Zdraveska M, Bounameaux H, Erdmann A, Mazzolai L, Ney B. Analysis of noncatheter-associated upper extremity deep venous thrombosis from the RIETE registry. J Vasc Surg Venous Lymphat Disord 2017; 5:18-24.e1. [DOI: 10.1016/j.jvsv.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/12/2016] [Indexed: 11/25/2022]
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Percutaneous placement of large cannula into the internal jugular vein for minimally invasive surgery: Where do we go? J Thorac Cardiovasc Surg 2016; 152:1600-1601. [PMID: 27692761 DOI: 10.1016/j.jtcvs.2016.08.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 11/23/2022]
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Abstract
Upper extremity deep vein thrombosis is a relatively rare condition which has thus far not attracted much interest in the literature. The differences in its aetiopathology, different diagnostic modalities and the current standard of care are discussed in this article.
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Affiliation(s)
- Mark Porteous
- Medical Student in the University of Manchester, Manchester
| | - Jecko Thachil
- Consultant Haematologist in the Department of Haematology, Manchester Royal Infirmary, Manchester M13 9WL
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14
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Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: literature review: part 1. JOURNAL OF INFUSION NURSING 2015; 37:187-96. [PMID: 24694512 DOI: 10.1097/nan.0000000000000037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This is part 1 of a 2-part series of articles that report on the results of a prospective observational cohort study designed to examine the risk factors associated with symptomatic upper extremity deep vein thrombosis (UEDVT) in patients with peripherally inserted central catheters. This article provides an extensive review and critique of the literature that serves to explicate what is currently known about risk factors associated with catheter-related UEDVT. Risk factors such as anticoagulant use, cancer, infection, hypertension, catheter tip placement, and catheter size were identified most frequently in the literature as being associated with UEDVT development. Other risk factors--such as obesity, smoking history, surgery, and presence of pain or edema--were examined in a limited number of studies and lacked consistent evidence of their impact on UEDVT development. The subsequent study that evolved from the review of the literature investigates the relationship between identified risk factors and UEDVT development.
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15
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Galyfos G, Palogos K, Kavouras N. Septic internal jugular vein thrombosis caused by Fusobacterium necrophorum and mediated by a broken needle. ACTA ACUST UNITED AC 2014; 46:911-5. [DOI: 10.3109/00365548.2014.952247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Mino JS, Gutnick JR, Monteiro R, Anzlovar N, Siperstein AE. Line-associated thrombosis as the major cause of hospital-acquired deep vein thromboses: an analysis from National Surgical Quality Improvement Program data and a call to reassess prophylaxis strategies. Am J Surg 2014; 208:45-9. [DOI: 10.1016/j.amjsurg.2013.08.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 06/14/2013] [Accepted: 08/01/2013] [Indexed: 11/24/2022]
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17
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Soo Hoo GW. Overview and assessment of risk factors for pulmonary embolism. Expert Rev Respir Med 2013; 7:171-91. [PMID: 23547993 DOI: 10.1586/ers.13.7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Pulmonary embolism is one of the most common undiagnosed conditions affecting hospitalized patients. There are a plethora of risk factors for venous thromboembolism and pulmonary emboli. These factors are grouped under the broad triad of hypercoagulability, stasis and injury to provide a framework for understanding. Important risk factors include inherited thrombophilia, age, malignancy and estrogens. These risk factors are reviewed in detail and several risk assessment models are reviewed. These risk assessment models help identify those at risk for disease and therefore candidates for thromboprophylaxis. Diagnosis can be difficult and is aided by clinical decision rules that incorporate clinical scores that define the likelihood of pulmonary embolism. These are important considerations, not only for diagnostic purposes, but also to minimize excessive use of imaging, which increases exposure to and risks associated with radiation. A healthy index of suspicion is often the key to diagnosis.
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Affiliation(s)
- Guy W Soo Hoo
- Pulmonary and Critical Care Section, West Los Angeles Veterans Affairs Healthcare Center, Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Wehrenberg-Klee E, Stavropoulos SW. Inferior vena cava filters for primary prophylaxis: when are they indicated? Semin Intervent Radiol 2013; 29:29-35. [PMID: 23450194 DOI: 10.1055/s-0032-1302449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Over the past several years there has been a rapid increase in the number of inferior vena cava (IVC) filters placed for primary thromboprophylaxis. Increased use has occurred in settings where other methods of thromboprophylaxis are viewed to be inadequate, technically challenging, or that place patients at an unacceptably high bleeding risk. These clinical services include trauma, bariatric surgery, neurosurgery, cancer, intensive care unit populations, and patients with a relative contraindication to anticoagulation. We review the studies to date addressing filter placement for these indications. Although preliminary data are promising, the patient populations most likely to benefit from prophylactic IVC filter placement have not been well defined, and randomized studies demonstrating efficacy have not been conducted. Moving forward, it will be critical to accomplish these two tasks if IVC filters are to continue to have a role in primary thromboprophylaxis.
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Affiliation(s)
- Eric Wehrenberg-Klee
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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19
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Tan WF, Ma H. Fatal pulmonary embolism in a patient with thromboembolism of the internal jugular vein after liver transplant. Prog Transplant 2012. [PMID: 23187052 DOI: 10.7182/pit2012263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A patient with acute liver failure and thromboembolism of the internal jugular vein subsequently had a massive pulmonary embolism and died 25 days after orthotopic liver transplant. The primary cause of death was massive pulmonary embolus. This case report highlights the need for clinicians to be aware that fatal embolic events can occur in liver transplant recipients, even when routine prophylactic procedures are implemented. The benefits and risks of invasive strategies, including placement of superior vena cava filters, should be considered on a case-by-case basis.
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Affiliation(s)
- Wen-Fei Tan
- The First Hospital of China Medical University, Shenyang, China
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Les thromboses veineuses profondes des membres supérieurs. Rev Med Interne 2011; 32:567-74. [DOI: 10.1016/j.revmed.2010.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 05/03/2010] [Accepted: 08/16/2010] [Indexed: 11/18/2022]
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21
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Gbaguidi X, Janvresse A, Benichou J, Cailleux N, Levesque H, Marie I. Internal jugular vein thrombosis: outcome and risk factors. QJM 2011; 104:209-19. [PMID: 20974769 DOI: 10.1093/qjmed/hcq179] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The aims of this study were to analyse the characteristics of patients with internal jugular venous thrombosis. We compared the characteristics of patients with internal jugular venous thrombosis with those of patients exhibiting upper extremity deep venous thrombosis (UEDVT) without internal jugular vein involvement. PATIENTS From 1998 to 2007, 1948 consecutive patients were referred to our Department of Internal Medicine for deep venous thrombosis. RESULTS Sixty-four patients exhibited UEDVT. Internal jugular venous thrombosis was diagnosed in 29 patients. Twenty-three patients had secondary thrombosis mainly due to cancer, central venous catheter and ovarian hyperstimulation syndrome; three of the four patients with bilateral DVT exhibited cancer. Six patients had primary internal jugular vein thrombosis. Complications of internal jugular vein thrombosis were pulmonary embolism (10.3%) and post-thrombotic syndrome (41.4%). Under multivariate analysis, significant factors for internal jugular vein thrombosis were older patients (P = 0.0008), female gender (P = 0.0035) and ovarian hyperstimulation syndrome (P = 0.0093). CONCLUSION Our study underscores that the most common causes of internal jugular vein thrombosis are cancer, central venous catheter and ovarian hyperstimulation syndrome; it also underlines that bilateral internal jugular vein thrombosis is a significant risk indicator of malignancy Thrombosis led to high morbidity related to pulmonary embolism and post-thrombotic syndrome, principally in patients with secondary DVT. The knowledge of predictive factors of internal jugular vein thrombosis seems to be of utmost importance to improve patients' management.
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Affiliation(s)
- X Gbaguidi
- Department of Internal Medicine, Rouen University Hospital, 76031 Rouen Cedex, France
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22
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Honma H, Ohno T, Matsuzaki T, Mizuno K. Idiopathic internal jugular vein thrombosis in a patient with severe dizziness. J Echocardiogr 2011; 9:119-20. [PMID: 27277182 DOI: 10.1007/s12574-011-0083-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/22/2010] [Accepted: 01/11/2011] [Indexed: 11/26/2022]
Abstract
Upper torso deep vein thrombosis usually occurs in association with an indwelling venous catheter and/or malignancy as part of a paraneoplastic syndrome. However, idiopathic internal jugular vein thrombosis is a rare but potentially fatal condition. We report a 59-year-old woman who presented with severe dizziness. Ultrasonography and contrast-enhanced multislice computed tomography revealed thrombi in the left internal jugular vein. This patient had no malignancy, coagulation disorder, or infection. A ventilation/perfusion scan of the lungs showed no evidence of pulmonary embolism. This is a rare case of idiopathic thrombosis of the internal jugular vein.
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Affiliation(s)
- Hiroshi Honma
- Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - Tadaaki Ohno
- Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Tsuyako Matsuzaki
- Laboratory of Ultrasonography, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Kyoichi Mizuno
- Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Togashi Y, Kim YH, Masago K, Tamai K, Sakamori Y, Mio T, Mishima M. Pulmonary embolism due to internal jugular vein thrombosis in a patient with non-small cell lung cancer receiving bevacizumab. Int J Clin Oncol 2010; 16:444-6. [PMID: 21116671 DOI: 10.1007/s10147-010-0148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 11/01/2010] [Indexed: 12/21/2022]
Abstract
Internal jugular vein thrombosis is much less common than deep venous thrombosis of lower limbs and is generally caused by an indwelling venous catheter or otological infection. Several cases of internal jugular vein thrombosis associated with malignancy have been also reported. Bevacizumab, a monoclonal neutralizing antibody against vascular endothelial growth factor, has shown benefits in the treatment of many types of malignancy and its use is increasing. Serious adverse effects, however, are associated with the use of bevacizumab, including venous thromboembolism. In this article, we present a rare case of non-small cell lung cancer complicated by pulmonary embolism due to internal jugular vein thrombosis associated with bevacizumab.
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Affiliation(s)
- Yosuke Togashi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, 606-8507, Japan
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Owens CA, Bui JT, Knuttinen MG, Gaba RC, Carrillo TC. Pulmonary embolism from upper extremity deep vein thrombosis and the role of superior vena cava filters: a review of the literature. J Vasc Interv Radiol 2010; 21:779-87. [PMID: 20434365 DOI: 10.1016/j.jvir.2010.02.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 02/17/2010] [Accepted: 02/25/2010] [Indexed: 12/16/2022] Open
Abstract
The placement of superior vena cava (SVC) filters to prevent pulmonary emboli (PE) from upper-extremity deep vein thrombosis (UEDVT), although controversial, has been reported. A total of 21 publications were identified that reported 209 SVC filters and documented eight major filter-related complications (3.8%), including four cardiac tamponades, two aortic perforations, and one recurrent pneumothorax. The in-hospital or 1-month mortality rate was 43.1%. Twenty-eight additional publications were identified that reported 3,747 cases of UEDVT. The rates of PE and associated mortality were 5.6% and 0.7%, respectively. Studies imaging both upper and lower extremities found deep vein thrombus 14.7 times more likely to occur in the lower extremities and the rate of PE from a lower-extremity thrombus to be 25.1%. The lack of evidence documenting the risk from UEDVT and the absence of data supporting the safety and efficacy of SVC filters bring their benefit into question.
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Affiliation(s)
- Charles A Owens
- Division of Interventional Radiology, University of Illinois Medical Center, M/C 931, 1740 West Taylor Street, Chicago, IL 60612, USA.
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25
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Incidental detection of internal jugular vein thrombosis secondary to undiagnosed benign substernal goiter. Case Rep Med 2010; 2010. [PMID: 20814560 PMCID: PMC2931408 DOI: 10.1155/2010/645193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 06/07/2010] [Accepted: 06/25/2010] [Indexed: 01/19/2023] Open
Abstract
Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right lobe, causing compression and displacement of the great vessels. A successful, one-stage operation including ligation of the internal jugular vein to avoid pulmonary embolism and hemithyroidectomy, combined with the scheduled CABG and AVR, was performed.
This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.
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Collet-sicard syndrome from thrombosis of the sigmoid-jugular complex: a case report and review of the literature. Int J Otolaryngol 2010; 2010. [PMID: 20706543 PMCID: PMC2913533 DOI: 10.1155/2010/203587] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Accepted: 06/16/2010] [Indexed: 11/17/2022] Open
Abstract
Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX-XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein. Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery.
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Martin MJ, Blair KS, Curry TK, Singh N. Vena Cava Filters: Current Concepts and Controversies for the Surgeon. Curr Probl Surg 2010; 47:524-618. [DOI: 10.1067/j.cpsurg.2010.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Naganuma T, Dote K, Kato M, Sasaki S, Ueda K, Kono Y, Watanabe Y, Kajikawa M, Yokoyama H. Pulmonary embolism due to internal jugular vein thrombosis without an indwelling catheter. Intern Med 2009; 48:433-6. [PMID: 19293542 DOI: 10.2169/internalmedicine.48.1551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 65-year-old man who had undergone retropubic prostatectomy for prostate adenocarcinoma presented with sudden dyspnea and chest pain. Contrast-enhanced multi-slice computed tomography (MSCT) revealed thrombi in the left internal jugular vein (IJV) and in branches of the right pulmonary artery. Ultrasonography showed that the thrombus which occluded the left IJV was hypoechoic and mobile. After beginning anticoagulant therapy, he again presented with dyspnea and transient hypotension. MSCT and ultrasonography showed that the IJV thrombus had moved and caused a new embolism of the left pulmonary artery branch. This is a rare case of a patient who experienced non-catheter-related thrombosis of the IJV.
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Affiliation(s)
- Toru Naganuma
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima.
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[Superior vena cava syndrome: cause of secondary raise of intracranial pressure after traumatic brain injury]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2008; 27:850-3. [PMID: 18835126 DOI: 10.1016/j.annfar.2008.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 08/21/2008] [Indexed: 11/23/2022]
Abstract
A 41-year-old male is admitted for cranial trauma, having fallen from his own height. His state of extreme agitation imposes sedation, intubation and mechanical ventilation. A CT-scan reveals acute right hemispheric subdural haematoma, with discrete midline shift, and diffuse cerebral oedema. ICP-monitoring reveals severely increased intracranial pressure, which is responsive to routine medical neuroprotective treatment. Ten days after admission, sedation and neuroprotective treatment is gradually withdrawn. At the end of the second week, a secondary ascent in ICP is observed. The presence of a right subclavian central venous line, in combination with the strong inflammatory response and septic state of the patient, has caused bilateral thrombosis of subclavian and internal jugular veins. This superior vena cava syndrome (SVCS) impedes cerebral venous drainage, thus raising ICP. Within a few days of anticoagulant therapy, SVCS resolved. Impeded cerebral venous drainage is often forgotten or ignored as a cause of secondary elevated ICP. In face of persisting or recurring raised ICP and cerebral oedema, or apparition of communicant hydrocephalus, cerebral venous drainage should be investigated.
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