Ultrasonographically detected central venous catheter-related thrombosis in patient undergoing anticoagulation therapy during anesthetic induction

Corresponding author Eun-Ho Lee Department of Anesthesiology and Pain Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3888 Fax: +82-2-470-1363 E-mail: leho@naver.com ORCID: https://orcid.org/0000-0002-6369-7429 Catheter-related thrombosis (CRT) is a common complication of central venous catheter inserted into the internal jugular vein or subclavian vein. Most CRT is resolved with thrombolytic therapy without additional complications such as pulmonary embolism, deep vein thrombosis, or post-thrombotic syndrome. Unusually, we experienced asymptomatic CRT occurred in a patient undergoing anticoagulation therapy. Central venous catheter was inserted into the right subclavian vein and the patient received heparin therapy for treatment of myocardial infarction for 16 days before surgery. Thrombus was detected during ultrasonographic examination when placing additional central venous catheter with a SwanGanz catheter after induction of general anesthesia. The catheter with a thrombus was removed 5 hours after off pump coronary artery bypass surgery. Heparin therapy was started 24 hours after surgery and continued for three days owing to CRT. The patient received anticoagulation therapy including warfarin and aspirin consistently. He was discharged at 15 days after surgery.