P108 | Catheter-related thrombosis vs. fibroblastic sleeve. Incidence and impact in oncological and hematological patients with peripherally inserted central catheter

M. Nunziata, S. Mangiacapra, F. Cannavacciuolo, F. Damiano, M. Amitrano | AORN Moscati di Avellino, Italy

Background: More and more oncological patients are implanting peripherally inserted central venous catheters for the administration of therapy. Associated complications include thrombosis and fibroblastic sleeve. Their correct discrimination can be difficult, but their management turns out to be completely different. Few studies have investigated the incidence of these complications.
Materials and Methods: In a cohort of oncological patients with PICC, we evaluated the incidence of catheter-related thrombosis and fibroblastic sleeve at 7-10 and 28-30 days. We enrolled 45 patients with polyurethane (4Fr) PICCs. We also correlated the results with the type of underlying oncological disease.
Results: The fibroblastic sleeve was identified by ultrasound in 11 patients (24.4%): 6 times at 7-10 days (13.3%) and 5 times at 28-30 days (11.1%). Catheter-related thrombosis was identified by ultrasound in 5 patients (11.1%): 3 times at 7-10 days (60.0%) and 2 times at 28-30 days (40.0%).At the limits of significance (p-value 0.069) the relationship between vein diameter and development of fibroblastic sleeve/thrombosis. Statistically significant (p-value 0.039) the relationship between the timing of the complication and the number of platelets.
Discussion: Fibroblastic sleeve is a frequent finding (24.4%), but asymptomatic, in oncological patients. Less frequent (11.1%), but with significant consequences, is catheter-related thrombosis. Discrimination between these two complications is clinically relevant as almost one in four patients could undergo unnecessary anticoagulant therapy.