Outcome of catheter associated upper extremity deep vein thrombosis in cancer: A two year prospective study with enoxaparin

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2026-07-01 Epub Date: 2026-06-18 DOI:10.1016/j.thromres.2026.109755

Michelangelo Sartori, Alice Trentini, Sofia Cavara, Elisabetta Favaretto, Laura Borgese, Mario Soldati, Benilde Cosmi

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引用次数: 0

Abstract

Background

Current guidelines suggest three month anticoagulation for the treatment of catheter-related upper extremity deep vein thrombosis (CRT), but few data are available on outcome beyond three months in cancer patients.

Methods

This was a prospective, single center study to ascertain the long term venous thromboembolism (VTE) recurrences for CRT in cancer patients. We enrolled 233 participants (age: 56.8 ± 16.6y, female: 58.4%) who received enoxaparin for 3 months. The follow-up was 24 months and the primary outcome was the composite measure of recurrent VTE.

Findings

182 (78.1%) patients received therapeutic enoxaparin for 3 months whereas 51 (21.9%) patients continued therapeutic enoxaparin for 6 months. During the follow-up, the primary outcome occurred in 32 (13.7%) patients for a cumulative incidence rate of 9.2/100 patient years (95%CI: 6.6–12.7).There were: 28 (12.0%) CRT recurrences for a cumulative incident rate of 8.1/100 patient years, 3 (1.3%) pulmonary embolisms (0.9/100 patient years), and one (0.4%) cerebral venous sinus thrombosis (0.3/100 patient years). No patients in cancer remission had VTE recurrences. In multivariable modeling, insertion of a new vascular device (SHR 3.00, 95%CI: 1.14–7.88; p = 0.026) and the use prophylactic enoxaparin (SHR 0.05, 95%CI: 0.01–0.20; p < 0.001) were associated with the primary outcome, whereas the duration of therapeutic enoxaparin was not.

Interpretation

Recurrent VTE was not infrequent in subgroups of patients with CRT; these data may lead to improved risk stratification and to tailored management strategies.

查看原文本刊更多论文

癌症患者导管相关性上肢深静脉血栓的预后：一项使用依诺肝素的两年前瞻性研究。

背景：目前的指南建议3个月的抗凝治疗导管相关性上肢深静脉血栓形成（CRT），但很少有数据表明癌症患者超过3个月的结果。方法：这是一项前瞻性的单中心研究，旨在确定癌症患者接受CRT治疗后的长期静脉血栓栓塞（VTE）复发情况。我们招募了233名受试者（年龄：56.8±16.6岁，女性：58.4%），接受依诺肝素治疗3个月。随访24个月，主要指标为静脉血栓栓塞复发的综合指标。结果：182例（78.1%）患者接受治疗性依诺肝素治疗3个月，51例（21.9%）患者继续接受治疗6个月。在随访期间，32例（13.7%）患者出现主要结局，累积发病率为9.2/100患者年（95%CI: 6.6-12.7）。有28例（12.0%）CRT复发，累计发病率为8.1/100患者年，3例（1.3%）肺栓塞（0.9/100患者年），1例（0.4%）脑静脉窦血栓形成（0.3/100患者年）。癌症缓解期患者无静脉血栓栓塞复发。在多变量模型中，插入新的血管装置（SHR 3.00, 95%CI: 1.14-7.88; p = 0.026）和预防性使用依诺肝素（SHR 0.05, 95%CI: 0.01-0.20; p）解释：静脉血栓栓塞复发在CRT患者亚组中并不罕见；这些数据可能导致改进的风险分层和量身定制的管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.