Thrombotic complications of subclavian apheresis catheters in cancer patients

Prevention with heparin infusion

William D. Haire, James Augustine Edney, James Dale Landmark, Margaret Anne Kessinger

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Twenty‐two silicone rubber apheresis catheters were placed into the subclavian veins of 18 cancer patients to allow serial leukapheresis for collection of circulating hematopoietic stem cells. The tips of the catheters were placed in the innominate vein to avoid reinfusion of citrate into the right atrium and the resulting tendency to cardiac arrhythmias. Sixteen catheters were placed without prophylactic anticoagulation. Anticoagulation was prematurely discontinued in one patient because of the inconvenience of the portable heparin infusion pump. Six of these 17 catheters developed venographically proven thrombotic complications and five others had presumed thrombosis‐related access failure or caused symptoms of venous obstruction, but confirmation of the presence of a thrombus with venography was not obtained. Three catheters spontaneously withdrew from the vein, one during urokinase infusion for thrombosis. Only three catheters had uncomplicated apheresis courses. Prophylactic heparin infusions via portable infusion pumps were given after placement of six catheters. As long as the heparin infusions were continued all patients had uncomplicated apheresis courses. One patient's heparin was prematurely discontinued. Within 3 days of its discontinuance, radiographically proven thrombotic catheter occlusion occurred. Patients given heparin were less likely to develop complications (P lt; 0.001). No unexpected complications of apheresis were encountered as a result of the use of these catheters. Silicone rubber subclavian catheters can be used for peripheral stem cell collection but have a high frequency of thrombotic complications. Systemic anticoagulation with heparin can minimize the likelihood of these complications.

Original languageEnglish (US)
Pages (from-to)188-191
Number of pages4
JournalJournal of Clinical Apheresis
Volume5
Issue number4
DOIs
StatePublished - Jan 1 1990

Fingerprint

Blood Component Removal
Heparin
Catheters
Neoplasms
Infusion Pumps
Silicone Elastomers
Thrombosis
Brachiocephalic Veins
Leukapheresis
Subclavian Vein
Phlebography
Urokinase-Type Plasminogen Activator
Hematopoietic Stem Cells
Heart Atria
Citric Acid
Cardiac Arrhythmias
Veins

Keywords

  • anticoagulation
  • leukopheresis
  • stem cell transplantation
  • thrombosis

ASJC Scopus subject areas

  • Hematology

Cite this

Thrombotic complications of subclavian apheresis catheters in cancer patients : Prevention with heparin infusion. / Haire, William D.; Edney, James Augustine; Landmark, James Dale; Kessinger, Margaret Anne.

In: Journal of Clinical Apheresis, Vol. 5, No. 4, 01.01.1990, p. 188-191.

Research output: Contribution to journalArticle

Haire, William D. ; Edney, James Augustine ; Landmark, James Dale ; Kessinger, Margaret Anne. / Thrombotic complications of subclavian apheresis catheters in cancer patients : Prevention with heparin infusion. In: Journal of Clinical Apheresis. 1990 ; Vol. 5, No. 4. pp. 188-191.
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