Adam Suleman1, Virginia Jarvis2, Adnan Hadziomerovic3, Marc Carrier4, Sheryl McDiarmid5. 1. The University of Ottawa, 451 Smyth Rd., Ottawa, Ontario K1H8M5, Canada. Electronic address: asule095@uottawa.ca. 2. The Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada. Electronic address: gjarvis@toh.ca. 3. The Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada; Department of Medical Imaging, University of Ottawa, 501 Smyth Rd., Ottawa, Ontario K1H8L6, Canada. Electronic address: ahadziomerovic@toh.ca. 4. The University of Ottawa, 451 Smyth Rd., Ottawa, Ontario K1H8M5, Canada; The Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada; Department of Medicine, University of Ottawa, Box 201a, 501 Smyth Rd., Ottawa, Ontario K1H8L6, Canada. Electronic address: mcarrier@toh.ca. 5. The Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada; The Ottawa Hospital, Box 710, 501 Smyth Rd., Ottawa, Ontario K1H 8L6, Canada. Electronic address: smcdiarmid@toh.ca.
Abstract
BACKGROUND: Implanted vascular access devices (IVADs) have significantly improved the management of cancer patients. These patients are at an increased risk of venous thromboembolism and IVADs are a known risk factor. We sought to assess the incidence of IVAD-related upper extremity deep vein thrombosis (IVAD-related UEDVT) associated with BioFlo® IVADs (Angiodynamics, Inc.). METHODS: A total of 394 cancer patients were enrolled over 12 months. The primary outcome was the incidence of IVAD-related UEDVT confirmed by diagnostic imaging. IVAD-related UEDVT was defined as symptomatic ipsilateral upper extremity (axillary vein or proximal) deep vein thrombosis and symptomatic pulmonary embolism (PE). Patients were followed until initiation of therapeutic anticoagulation, catheter removal, death, or up to 12 months. RESULTS: 389 patients were included in the analysis. The median age of the cohort was 58.2 years; 68% (n = 273) were females. Sixty-six percent had gastrointestional cancer (including pancreatic cancer) and 68% had metastases. Eighty four percent of IVADs were right sided insertions. Ninety eight percent of catheter tip placements were distal superior vena cava (n = 237), cavo-atrial junction (n = 67) or atrium (n = 90). Overall, 5 patients had symptomatic IVAD-related UEDVT (1.29%, 95% CI 0.2 to 2.4%). CONCLUSION: IVAD-related UEDVT is an infrequent complication in cancer patients with BioFlo® IVADs.
BACKGROUND: Implanted vascular access devices (IVADs) have significantly improved the management of cancerpatients. These patients are at an increased risk of venous thromboembolism and IVADs are a known risk factor. We sought to assess the incidence of IVAD-related upper extremity deep vein thrombosis (IVAD-related UEDVT) associated with BioFlo® IVADs (Angiodynamics, Inc.). METHODS: A total of 394 cancerpatients were enrolled over 12 months. The primary outcome was the incidence of IVAD-related UEDVT confirmed by diagnostic imaging. IVAD-related UEDVT was defined as symptomatic ipsilateral upper extremity (axillary vein or proximal) deep vein thrombosis and symptomatic pulmonary embolism (PE). Patients were followed until initiation of therapeutic anticoagulation, catheter removal, death, or up to 12 months. RESULTS: 389 patients were included in the analysis. The median age of the cohort was 58.2 years; 68% (n = 273) were females. Sixty-six percent had gastrointestional cancer (including pancreatic cancer) and 68% had metastases. Eighty four percent of IVADs were right sided insertions. Ninety eight percent of catheter tip placements were distal superior vena cava (n = 237), cavo-atrial junction (n = 67) or atrium (n = 90). Overall, 5 patients had symptomatic IVAD-related UEDVT (1.29%, 95% CI 0.2 to 2.4%). CONCLUSION: IVAD-related UEDVT is an infrequent complication in cancerpatients with BioFlo® IVADs.