LITERATURE REVIEW

ARTICLE REVIEW

Catheter-Associated Thrombosis:Thromboprophylaxis or Not?Levine M, Kakkar AKJ Clin Oncol. 2005;23:4006-4008

001: 1O.2309/java.II-I-8

C atheter-related thrombosis haslong been acknowledged as apotential complication for any

patient receiving a central venous accessdevice (CVAD). This editorial, written byLevine and Kakkar. reviews four trialswhere either low-dose warfarin or low-dose,molecular-weight heparin was used asthrombosis prophylaxis in patients who hadcancer and CVADs.

The authors suggest that two of the ear­lier trials that have been reviewed mayhave overestimated the incidence ofcatheter-related thrombosis.'" The authorsalso suggest that improvements in catheterconstruction materials and insertion andmaintenance techniques have contributedto the lower incidence of catheter-relatedthrombosis in recent years. On the basis ofthe results from these studies, Levine andKakkar assert that it is difficult to supportthe use of anti thrombotic prophylaxis inpatients with CVADs who have cancer.However, the authors acknowledge thatadditional, large-seale studies are required.

ReferencesI. Mooreal M, Alastrue A, Rull M, et al.

Upper extremity deep venous thrombo­sis in cancer patients with venousaccess devices--prophylaxis with a lowmolecular weight heparin (Fragmin).Thromb Haemost. 1996;75:251-253.

2. Bern MM, Lokich JJ, Wallach S, et al.Very low doses ofwarfarin can preventthrombosis in central venous catheters.A raodornized prospective trial. AnnIntern Med. 1990;112:423-428.

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2006 Volll No I .JAVA 21