Department of Basic and Clinical Oncology, University of Chile Faculty of Medicine, Santiago, 8380453, Chile.
School of Medicine, University of Chile, Santiago, 8380453, Chile.
BMJ Support Palliat Care. 2021 Dec;11(4):371-380. doi: 10.1136/bmjspcare-2019-002106. Epub 2021 Aug 19.
The adequate handling of central venous catheters is a key element in the management of patients with cancer. Catheter-associated deep vein thrombosis is frequently observed in patients with malignant diseases; however, despite being a common complication among these patients, objective information concerning its epidemiology, clinical course, prophylaxis and treatment strategies is very limited. The reported incidence of catheter-related thrombosis (CRT) is highly variable, depending on symptomatic events, or if patients are screened for asymptomatic thrombosis. Several factors have been identified as potential predisposing factors for CRT, both technical and pathological aspects. The anticoagulant of choice is still unclear; while low-molecular-weight heparin is most commonly used, recent studies assessing the role of direct oral anticoagulants in the treatment of CRT show promise as an alternative, but the evidence remains insufficient and the decision must be made on a case-by-case basis.
妥善处理中心静脉导管是癌症患者管理的关键要素。导管相关性深静脉血栓形成在恶性疾病患者中经常观察到；然而，尽管这是这些患者的常见并发症，但关于其流行病学、临床病程、预防和治疗策略的客观信息非常有限。报告的导管相关性血栓形成（CRT）的发生率差异很大，这取决于有症状的事件，或者是否对无症状血栓形成进行筛查。已经确定了一些因素，这些因素可能是 CRT 的潜在诱发因素，包括技术和病理方面。抗凝药物的选择仍不明确；虽然低分子量肝素最常使用，但最近评估直接口服抗凝剂在 CRT 治疗中的作用的研究表明，它们是一种替代方法，但证据仍然不足，必须根据具体情况做出决定。
