Thrombotic complications of tunneled central lines in children with malignancy.

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.