Management of catheter-related septic thrombosis

Introduction

The use of intravascular catheters is associated with a risk of catheter-related septic thrombosis (CRST), which management remains highly variable due to a lack of robust scientific evidence. This study aimed to describe current practices in France through a systematic survey.

Methods

A web-based survey was disseminated via 10 French medical societies between June and October 2024.

Results

Among 156 respondents, 69 were infectious disease specialists. For catheter-related bloodstream infections, ultrasound imaging is not routinely performed by 60 % of respondents but is typically performed in the presence of local inflammatory signs or antimicrobial therapy (AMT) failure. Over 60 % of respondents reported prescribing AMT for ≤ 21 days. In cases of CRST involving a deep vein (DV), more than 80 % of respondents considered the use of curative anticoagulation. For proximal DV CRST, 126 of 156 (81 %) respondents performed follow-up ultrasound imaging to assess venous repermeabilization. The most frequently cited research priorities included the need for and appropriate use of anticoagulation (n = 71/156; 46 %), as well as AMT optimal duration (n = 47/156; 30 %).

Conclusion

Despite the heterogeneity in clinical practice, our findings highlight a prevailing trend toward prescribing AMT for ≤ 21 days and the use of curative anticoagulation in cases of DV thrombosis. However, these approaches require further investigation through well-designed studies to establish their benefit.