Treatment of Catheter-Related Arterial Thrombosis in Children: A 15-Year Single- Center Experience.
Details
Serval ID
serval:BIB_600FB12107EF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treatment of Catheter-Related Arterial Thrombosis in Children: A 15-Year Single- Center Experience.
Journal
The Journal of pediatrics
ISSN
1097-6833 (Electronic)
ISSN-L
0022-3476
Publication state
Published
Issued date
12/2021
Peer-reviewed
Oui
Volume
239
Pages
182-186
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To investigate treatment modalities for children with extremity indwelling catheter (EIC)- or cardiac catheter-related arterial thrombosis.
The treatment of consecutive cases of catheter-related arterial thrombosis (CAT) at our institution between 2002 and 2017 was analyzed retrospectively.
A total of 242 CATs developed in 224 children. Of these, 125 (52%) were EIC-related and 117 (48%) were cardiac catheter-related. Treatment included heparin alone in 60 cases (25%), acetylsalicyclic acid (ASA) alone in 6 cases (2%), heparin followed by ASA in 171 cases (71%), heparin followed by vitamin K antagonist (VKA) in 4 cases (1.5%), and VKA alone in 1 case (0.5%). Complete resolution of CAT was observed in 173 cases (71.5%), partial resolution in 13 cases (5.4%), and no resolution in 56 cases (23.1%). No statistical significance in the resolution rate was observed between treatment groups (P = .23). In 66% of cases, complete resolution occurred at a median of 18 days (range, 4-44 days) with heparin alone. A switch from heparin to ASA in children with partial or no resolution of CAT did not increase the resolution rate at follow-up.
Heparin is an efficient treatment modality for CAT in pediatric patients. Long-term, subsequent treatment with ASA does not increase the resolution rate.
The treatment of consecutive cases of catheter-related arterial thrombosis (CAT) at our institution between 2002 and 2017 was analyzed retrospectively.
A total of 242 CATs developed in 224 children. Of these, 125 (52%) were EIC-related and 117 (48%) were cardiac catheter-related. Treatment included heparin alone in 60 cases (25%), acetylsalicyclic acid (ASA) alone in 6 cases (2%), heparin followed by ASA in 171 cases (71%), heparin followed by vitamin K antagonist (VKA) in 4 cases (1.5%), and VKA alone in 1 case (0.5%). Complete resolution of CAT was observed in 173 cases (71.5%), partial resolution in 13 cases (5.4%), and no resolution in 56 cases (23.1%). No statistical significance in the resolution rate was observed between treatment groups (P = .23). In 66% of cases, complete resolution occurred at a median of 18 days (range, 4-44 days) with heparin alone. A switch from heparin to ASA in children with partial or no resolution of CAT did not increase the resolution rate at follow-up.
Heparin is an efficient treatment modality for CAT in pediatric patients. Long-term, subsequent treatment with ASA does not increase the resolution rate.
Keywords
Adolescent, Anticoagulants/therapeutic use, Aspirin/therapeutic use, Cardiac Catheterization/adverse effects, Catheters, Indwelling/adverse effects, Child, Child, Preschool, Drug Administration Schedule, Drug Therapy, Combination, Female, Femoral Artery, Fibrinolytic Agents/therapeutic use, Follow-Up Studies, Heparin/therapeutic use, Humans, Iliac Artery, Infant, Infant, Newborn, Male, Retrospective Studies, Thrombosis/drug therapy, Thrombosis/etiology, Treatment Outcome, Vitamin K/antagonists & inhibitors
Pubmed
Web of science
Create date
15/09/2021 10:43
Last modification date
18/08/2024 7:05