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Bazarbashi S, Alkhaldi T, Aseafan M, Melaibari M, Almuhisen S, Alharbi S, Alghabban A, Aljumaa J, Eldali A, Maraiki F, Owaidah T, Alzahrani H. Thromboembolic Events Burden in Patients With Solid Tumors and Their Predisposing Factors. Cureus 2022; 14:e23624. [PMID: 35386484 PMCID: PMC8967125 DOI: 10.7759/cureus.23624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction: The relationship between cancers and thromboembolic events is well established. In our study, we aim to determine the burden of thromboembolic events in patients with solid tumors and identify the risk factors related to their development. Materials & Methods: Data on patients with solid tumors and thromboembolism between January 2013 and September 2014 were collected and analyzed. Results: During the study period 174 patients were identified. Of which, 172 (98.9%) had venous thrombus embolism, 137 (79%) were diagnosed with deep vein thromboses, 67 (38.5%) with pulmonary embolism, 84 (48.3%) were symptomatic and 90 (51.7) were incidental at diagnosis. The most common patients and disease characteristics were female sex, high body mass index (BMI), metastatic stage, colorectal and breast primaries, and anti-neoplastic therapy. Conclusion: Our study confirmed the high burden of thromboembolic events in cancer patients and the relevant factors associated with its development.
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Brgdar A, Ojo AS, Rougui L, Anee K, Sumon M, Mehari A. Pulmonary Embolism and Chronic Superior Vena Cava Occlusion Complicating Central Line-Associated Venous Thromboembolism in a Sickle Cell Disease Patient. Cureus 2022; 14:e22113. [PMID: 35308691 PMCID: PMC8918275 DOI: 10.7759/cureus.22113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 12/05/2022] Open
Abstract
Sickle cell disease (SCD), the most common genetic disorder globally, is often associated with an increased risk of venous thromboembolic events (VTE). Many of these patients have central lines placed for the purposes of repeated medication administration, blood transfusions, and blood draw, further increasing the risk of VTE. Given the non-specific presentation of VTE and pulmonary embolism, as well as the risk of mortality if interventions are delayed, a high index of suspicion is required for early diagnosis of the condition. We report the case of a 35-year-old woman with SCD and a port-a-cath in place who presented with extensive upper extremity and intrathoracic VTE with associated pulmonary embolism and chronic superior vena cava (SVC) occlusion. We also discuss the peculiarities of the clinical manifestations and management of VTE and pulmonary embolism in the setting of SCD based on the evidence from existing literature.
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Kita K, Nakamura T, Nakamura K, Hagi T, Asanuma K, Sudo A. Deep vein thrombosis of the upper extremity caused by central venous port in a patient with soft tissue sarcoma: A case report. Mol Clin Oncol 2020; 13:89. [PMID: 33194195 DOI: 10.3892/mco.2020.2160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/29/2020] [Indexed: 11/06/2022] Open
Abstract
Deep vein thrombosis (DVT) more commonly occurs in the lower extremities, whereas involvement of the upper extremities is rare. The present case report describes the clinical course of the development and treatment of upper extremity DVT (UEDVT) following insertion of an indwelling central venous (CV) port in a patient with soft tissue sarcoma (STS) of the thigh. A 66-year-old man was referred to our hospital for STS treatment. The indwelling CV port was placed via the left subclavian vein, and two courses of neoadjuvant chemotherapy were administered. Two months after the catheter placement, DVT was detected from the left upper arm to the left internal jugular vein. Anticoagulation therapy with warfarin was started and DVT was undetectable at 5 months after surgery. In conclusion, DVT may occur in cancer patients who undergo treatment with indwelling CV ports. Therefore, screening should be conducted concurrently with surgical resection and chemotherapy for STS.
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Affiliation(s)
- Kouji Kita
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Tomoki Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Kouichi Nakamura
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Tomohito Hagi
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Kunihiro Asanuma
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Akihiro Sudo
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
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Implanted vascular access device related deep vein thrombosis in oncology patients: A prospective cohort study. Thromb Res 2019; 177:117-121. [DOI: 10.1016/j.thromres.2019.02.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/17/2019] [Accepted: 02/28/2019] [Indexed: 01/13/2023]
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Turnbull J. Is edaravone harmful? (A placebo is not a control). Amyotroph Lateral Scler Frontotemporal Degener 2018; 19:477-482. [PMID: 30373406 DOI: 10.1080/21678421.2018.1517179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Edaravone is delivered by long-term daily intravenous infusions, yet the risk of infusion was not considered in the design or analysis of studies examining the efficacy of edaravone in ALS. A reappraisal of the pivotal edaravone study (Study 19) on which claims of efficacy are based suggests that this risk cannot be dismissed, that the efficacy of edaravone may be over-estimated, and that some differences between edaravone and placebo may not implicate the ALS disease process. When trial conditions may be harmful to both arms of a placebo-controlled trial, not only is it necessary that treatment prove superior to placebo, but also that treatment is better than no intervention. In Study 19, edaravone performed better than placebo, but both placebo and edaravone likely did worse than no intervention, an interpretation more in keeping with previous trial experience of drugs with similar mechanisms of action, and with previous trial experience with edaravone. Edaravone, as presently delivered, may be both ineffective and harmful.
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Affiliation(s)
- John Turnbull
- a Department of Medicine, McMaster University , Hamilton , Canada
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Tippit D, Siegel E, Ochoa D, Pennisi A, Hill E, Merrill A, Rowe M, Henry-Tillman R, Ananthula A, Makhoul I. Upper-Extremity Deep Vein Thrombosis in Patients With Breast Cancer With Chest Versus Arm Central Venous Port Catheters. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2018; 12:1178223418771909. [PMID: 29881287 PMCID: PMC5987887 DOI: 10.1177/1178223418771909] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 03/29/2018] [Indexed: 12/31/2022]
Abstract
Most of the patients undergoing treatment for cancer require placement of a
totally implantable venous access device to facilitate safe delivery of
chemotherapy. However, implantable ports also increase the risk of deep vein
thrombosis and related complications in this high-risk population. The objective
of this study was to assess the incidence of upper-extremity deep vein
thrombosis (UEDVT) in patients with breast cancer to determine whether the risk
of UEDVT was higher with chest versus arm ports, as well as to determine the
importance of previously reported risk factors predisposing to UEDVT in the
setting of active cancer. We retrospectively reviewed the medical records of 297
women with breast cancer who had ports placed in our institution between the
dates of December 1, 2010, and December 31, 2016. The primary outcome was the
development of radiologically confirmed UEDVT ipsilateral to the implanted port.
Overall, 17 of 297 study subjects (5.7%) were found to have UEDVT. There was 1
documented case of associated pulmonary embolism. Fourteen (9.5%) of 147
subjects with arm ports experienced UEDVT compared with only 3 (2.0%) of 150
subjects with chest ports (P = .0056). Thus, implantation of
arm ports as opposed to chest ports may be associated with a higher rate of
UEDVT in patients with breast cancer.
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Affiliation(s)
- Danielle Tippit
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eric Siegel
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Daniella Ochoa
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Angela Pennisi
- Division of Medical Oncology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Erica Hill
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Amelia Merrill
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mark Rowe
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ronda Henry-Tillman
- Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aneesha Ananthula
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Issam Makhoul
- Division of Medical Oncology, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Takahashi T, Fukaya M, Miyata K, Sakatoku Y, Nagino M. Retrosternal Reconstruction Can be a Risk Factor for Upper Extremity Deep Vein Thrombosis After Esophagectomy. World J Surg 2017; 41:3154-3163. [DOI: 10.1007/s00268-017-4120-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ye X, Wong SW, Zhang J, Moo IH, Lee CC. Catheter-related upper limb venous thrombosis in a tertiary hospital setting. ANZ J Surg 2014; 86:1033-1037. [DOI: 10.1111/ans.12865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Xuan Ye
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
- Department of Surgery; Prince of Wales Hospital; Sydney New South Wales Australia
| | - Shing W. Wong
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
- Department of Surgery; Prince of Wales Hospital; Sydney New South Wales Australia
| | - John Zhang
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Ing-How Moo
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Chern Chuen Lee
- Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
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Administration of chemotherapy via the median cubital vein without implantable central venous access ports: port-free chemotherapy for metastatic colorectal cancer patients. Int J Clin Oncol 2014; 20:332-7. [DOI: 10.1007/s10147-014-0703-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/19/2014] [Indexed: 10/25/2022]
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Marcy PY, Thariat J, Lacout A, Sanglier J, Figl A, Chamorey E. Further data about catheter related venous thrombosis in oncology. Thromb Res 2014; 134:207-9. [PMID: 24792955 DOI: 10.1016/j.thromres.2014.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/05/2014] [Accepted: 04/07/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Pierre-Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, 332 Avenue Frederic Mistral, 83190 Ollioules.
| | - Juliette Thariat
- Department of Radiation Oncology, Antoine Lacassagne Cancer Research Institute, 33, Avenue Valombrose, 06189 Nice cedex1 France.
| | - Alexis Lacout
- Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac, France.
| | - Julie Sanglier
- Head&Neck and Interventional Radiology Department, Antoine Lacassagne Cancer Research Institute, 33, Avenue Valombrose, 06189 Nice cedex1 France.
| | - Andrea Figl
- Oncology breast surgery department, Antoine Lacassagne Cancer Research Center, 33 avenue Valombrose, 06189 NICE cedex 1 France.
| | - Emmanuel Chamorey
- Biostatistics Department, Head, Antoine Lacassagne Cancer Research Center, 33 avenue Valombrose, 06189 NICE cedex 1 France.
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Piran S, Ngo V, McDiarmid S, Le Gal G, Petrcich W, Carrier M. Incidence and risk factors of symptomatic venous thromboembolism related to implanted ports in cancer patients. Thromb Res 2014; 133:30-3. [DOI: 10.1016/j.thromres.2013.10.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/18/2013] [Accepted: 10/17/2013] [Indexed: 12/21/2022]
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Morichika K, Nakachi S, Tomoyose T, Shimabukuro N, Tamaki K, Tedokon I, Nishi Y, Hyakuna N, Fukushima T, Masuzaki H. A rare case of septic pulmonary embolism caused by infection-associated catheter removal in a patient with Hodgkin's lymphoma. Intern Med 2014; 53:1215-20. [PMID: 24881752 DOI: 10.2169/internalmedicine.53.2092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
As a reflection of the considerable increase in the number of cancer patients treated with chemotherapy, indications for the use of implanted venous catheters are rapidly growing. However, in some cases, implanted venous catheters induce unwelcome complications. We herein report a rare case of septic pulmonary embolism (SPE) caused by local infection-associated catheter removal during the administration of ABVd combination chemotherapy consisting of adriamycin, bleomycin, vinblastine and dacarbazine in a patient with Hodgkin's lymphoma of the mixed cellularity type. During the course of treatment with chemotherapy administered via implanted venous catheters, think it is crucial to monitor for the potential occurrence of SPE.
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Affiliation(s)
- Kazuho Morichika
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (The Second Department of Medicine), Ryukyu University Hospital, Japan
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Cooley C, Nishino M, Jagannathan J, Ramaiya N, Di Salvo D, Krajewski KM. Clinical problem solving: utility of sonography in oncologic patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:9-22. [PMID: 24371094 PMCID: PMC3970328 DOI: 10.7863/ultra.33.1.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This review demonstrates the unique advantages of sonography in the oncologic setting. Although computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are primary imaging modalities for evaluation of the oncologic patient, sonography is useful for evaluation of various conditions and clinical scenarios associated with cancer. The following article will illustrate the utility of sonography at a tertiary cancer center for diagnosis and problem solving.
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Affiliation(s)
- Christine Cooley
- Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02115 USA.
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Flow confirmation study for central venous port in oncologic outpatient undergoing chemotherapy: Evaluation of suspected system-related mechanical complications. Eur J Radiol 2013; 82:e691-6. [DOI: 10.1016/j.ejrad.2013.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 07/03/2013] [Accepted: 07/08/2013] [Indexed: 11/24/2022]
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Stevens KN, Croes S, Boersma RS, Stobberingh EE, van der Marel C, van der Veen FH, Knetsch ML, Koole LH. Hydrophilic surface coatings with embedded biocidal silver nanoparticles and sodium heparin for central venous catheters. Biomaterials 2011; 32:1264-9. [DOI: 10.1016/j.biomaterials.2010.10.042] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 10/19/2010] [Indexed: 01/25/2023]
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