Anne Munck1, Ahmed Kheniche2, Corinne Alberti3, Dominique Hubert4, Reynaud-Gaubert Martine5, Raphaele Nove-Josserand6, Isabelle Pin7, Francois Bremont8, Raphael Chiron9, Laure Couderc10, Marie Laure Dalphin11, Estelle Darviot12, Bertrand Delaisi13, Stéphane Dominique10, Isabelle Durieu6, Annelyse Fanton14, Michael Fayon15, Michèle Gérardin13, Jean-Louis Giniès12, Charlotte Giraut16, Dominique Grenet17, Marcel Guillot18, Frédéric Huet14, Muriel Le Bourgeois19, Marlène Murris-Epin20, Sophie Ramel21, Anne Sardet22, Isabelle Sermet-Gaudelus19, Françoise Varaigne23, Stéphanie Wanin24, Laurence Weiss25, Marie-Francoise Hurtaud26. 1. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paediatric Gastroenterology and Respiratory Department, CF Centre, Université Paris 7, France. Electronic address: anne.munck@rdb.aphp.fr. 2. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Imaging Department, Université Paris 7, France. 3. Université Paris Diderot, Sorbonne Paris Cité, France; Inserm, CIE 5, Paris, France; Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Clinical Epidemiology Unit, Paris, France. 4. Assistance publique-Hôpitaux de Paris, Hôpital Cochin, CF Centre, Université Paris Descartes, Sorbonne Paris Cité, France. 5. CF Centre, CHU Nord, Aix-Marseille Université, France. 6. Adult CF centre, Hospices Civils de Lyon, Groupe hospitalier Sud, Université de Lyon, France. 7. Pédiatrie, Pole Couple Enfants, CHU de Grenoble; INSERM U 823, Institut Albert Bonniot, Université Joseph Fournier, Grenoble, France. 8. CF centre, Hôpital d'enfants, Toulouse, France. 9. CF centre, Hôpital Arnaud de Villeneuve, Montpellier, France. 10. Department of Pneumology, Rouen University Hospital, France. 11. CF centre, Hopital Jean Minjoz, Besançon, France. 12. CF centre, Hôpital d' Angers, France. 13. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paediatric Gastroenterology and Respiratory Department, CF Centre, Université Paris 7, France. 14. CF centre, Hôpital d'enfants du Bocage, Dijon, France. 15. CF centre, Hopital Pellegrin CIC 005, CHU Bordeaux, France. 16. CF centre, Hôpital de Clocheville, Tours, France. 17. CF centre, Hôpital Foch, Suresnes, France. 18. CF centre, Hôpital Robert Bisson, Lisieux, France. 19. Assistance publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, CF centre, University Paris 5, France. 20. CF centre, Hôpital Larrey, Toulouse, France. 21. CF centre, Centre Perharidy, Roscoff, France. 22. CF centre, Hôpital de Lens, France. 23. CF centre, Hôpital Bretonneau, Tours, France. 24. Hospices Civils de Lyon, Hopital Femme-Mère-Enfant, CF centre, Bron, France. 25. CF centre, Hôpital de Hautepierre, Strasbourg, France. 26. Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Biological Hematology Department, Université Paris 7, France.
Abstract
BACKGROUND AND AIMS: Catheter venous thrombosis may result in life-threatening embolic complications. Recently, a thrombophilic tendency was described in cystic fibrosis (CF), the significance of which remains unclear. The aims of this study were to (1) document the frequency of catheter venous thrombosis detected by colour-Doppler-ultrasound (Doppler-US), (2) assess genetic and acquired thrombophilia risk factors for catheter venous thrombosis and hypercoagulability status and (3) provide recommendations on laboratory screening when considering insertion of a totally implantable vascular access device (TIVAD) in CF patients. METHODS: We designed a multicentre prospective study in patients selected at the time of catheter insertion. Doppler-US was scheduled at 1 and 6months after insertion and before insertion in case of a previous central line. Blood samplings were drawn at insertion and at 1 and 6months later. RESULTS: One-hundred patients received a TIVAD and 90 completed the 6-month study. Prevalence of thrombophilia abnormalities and hypercoagulability was found in 50% of the cohorts. Conversely, catheter venous thrombosis frequency was low (6.6%). CONCLUSION: Our data do not support biological screening at the time of a TIVAD insertion. We emphasise the contribution of a medical history of venous thromboembolism and prospective Doppler-US for identifying asymptomatic catheter venous thrombosis to select patients who may benefit from biological screening and possible anticoagulant therapy.
BACKGROUND AND AIMS: Catheter venous thrombosis may result in life-threatening embolic complications. Recently, a thrombophilic tendency was described in cystic fibrosis (CF), the significance of which remains unclear. The aims of this study were to (1) document the frequency of catheter venous thrombosis detected by colour-Doppler-ultrasound (Doppler-US), (2) assess genetic and acquired thrombophilia risk factors for catheter venous thrombosis and hypercoagulability status and (3) provide recommendations on laboratory screening when considering insertion of a totally implantable vascular access device (TIVAD) in CFpatients. METHODS: We designed a multicentre prospective study in patients selected at the time of catheter insertion. Doppler-US was scheduled at 1 and 6months after insertion and before insertion in case of a previous central line. Blood samplings were drawn at insertion and at 1 and 6months later. RESULTS: One-hundred patients received a TIVAD and 90 completed the 6-month study. Prevalence of thrombophilia abnormalities and hypercoagulability was found in 50% of the cohorts. Conversely, catheter venous thrombosis frequency was low (6.6%). CONCLUSION: Our data do not support biological screening at the time of a TIVAD insertion. We emphasise the contribution of a medical history of venous thromboembolism and prospective Doppler-US for identifying asymptomatic catheter venous thrombosis to select patients who may benefit from biological screening and possible anticoagulant therapy.
Authors: Kathleen Suzanne Mahan; Hamna Ahmad; Andrew George Keenan; Matthew Erren Prekker; Robert Ralph Kempainen Journal: Clin Respir J Date: 2022-01-21 Impact factor: 1.761