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Large PICC Size May Up Risk for Thrombosis in Cancer Patients

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(HealthDay News) — Cancer patients receiving chemotherapy intravenously have more than double the risk for developing a blood clot if the catheter occupies more than 45 percent of the vein, according to a study recently published online in BMJ Open.

Rebecca Sharp, Ph.D., from the University of South Australia in Adelaide, and colleagues assessed the effect of the catheter-to-vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC). The analysis included data from 2,438 PICC insertions at four tertiary hospitals.

The researchers found that 1.6 percent of insertions resulted in cases of thrombosis. A 45 percent CVR cutoff (≤45 versus ≥46 percent) predicted thrombosis, with those with a higher ratio having a significantly higher risk (relative risk, 2.30). Findings were similar when only those with malignancy were included in the analysis. With a 33 percent CVR cutoff, there was no significant association observed with thrombosis either overall or in those with malignancy. There were no significant associations seen for thrombosis with either the 33 or 45 percent CVR cutoff in those with infection or other nonmalignant conditions.


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“Adherence to CVR cutoffs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45 percent should be considered to minimize risk of thrombosis,” the authors write. “Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a nonmalignant diagnosis.”

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