Horne M K, May D J, Alexander H R, Steinhaus E P, Whitman E D, Chang R C, Doppman J L
Clinical Pathology Department, Warren G. Magnuson Clinical Center, Bethesda, MD 20892, USA.
Ann Surg Oncol. 1995 Mar;2(2):174-8. doi: 10.1007/BF02303635.
Tunneled venous access devices (VADs) are often essential in the care of patients with advanced malignancies, but they carry an uncertain risk of thrombosis.
To determine the incidence of venoocclusion related to silicone VADs in a population of adult oncology patients, we prospectively studied 50 individuals with upper extremity venograms approximately 6 weeks after their VADs had been implanted. Twenty-one of these patients were reevaluated with venograms approximately 12 weeks after catheterization. In addition, venograms were performed on a separate group of 24 patients who needed catheterization of axillary-subclavian veins that had been catheterized in the past.
The 6-week venograms in the prospective study showed partial venous obstruction in 15 patients (30%), whereas three (6%) had developed symptomatic total venoocclusion by this time. The 12-week venograms showed two additional complete occlusions. Venograms of 30 previously catheterized veins showed complete venoocclusion in nine (30%), although only two had a history of thrombosis.
Our observations indicate that VADs frequently cause partial venoocclusion within the first 6 weeks of catheterization and that permanent venous damage from VADs is common, even without a history of VAD-related thrombosis.
