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Central venous thrombosis and thrombophilia in cystic fibrosis: A prospective study.
J Cyst Fibros 2015; 14(1):97-103JC

Abstract

BACKGROUND AND AIMS

Catheter venous thrombosis may result in life-threatening embolic complications. Recently, a thrombophilic tendency was described in cystic fibrosis (CF), the significance of which remains unclear. The aims of this study were to (1) document the frequency of catheter venous thrombosis detected by colour-Doppler-ultrasound (Doppler-US), (2) assess genetic and acquired thrombophilia risk factors for catheter venous thrombosis and hypercoagulability status and (3) provide recommendations on laboratory screening when considering insertion of a totally implantable vascular access device (TIVAD) in CF patients.

METHODS

We designed a multicentre prospective study in patients selected at the time of catheter insertion. Doppler-US was scheduled at 1 and 6months after insertion and before insertion in case of a previous central line. Blood samplings were drawn at insertion and at 1 and 6months later.

RESULTS

One-hundred patients received a TIVAD and 90 completed the 6-month study. Prevalence of thrombophilia abnormalities and hypercoagulability was found in 50% of the cohorts. Conversely, catheter venous thrombosis frequency was low (6.6%).

CONCLUSION

Our data do not support biological screening at the time of a TIVAD insertion. We emphasise the contribution of a medical history of venous thromboembolism and prospective Doppler-US for identifying asymptomatic catheter venous thrombosis to select patients who may benefit from biological screening and possible anticoagulant therapy.

Authors+Show Affiliations

Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paediatric Gastroenterology and Respiratory Department, CF Centre, Université Paris 7, France. Electronic address: anne.munck@rdb.aphp.fr.Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Imaging Department, Université Paris 7, France.Université Paris Diderot, Sorbonne Paris Cité, France; Inserm, CIE 5, Paris, France; Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Clinical Epidemiology Unit, Paris, France.Assistance publique-Hôpitaux de Paris, Hôpital Cochin, CF Centre, Université Paris Descartes, Sorbonne Paris Cité, France.CF Centre, CHU Nord, Aix-Marseille Université, France.Adult CF centre, Hospices Civils de Lyon, Groupe hospitalier Sud, Université de Lyon, France.Pédiatrie, Pole Couple Enfants, CHU de Grenoble; INSERM U 823, Institut Albert Bonniot, Université Joseph Fournier, Grenoble, France.CF centre, Hôpital d'enfants, Toulouse, France.CF centre, Hôpital Arnaud de Villeneuve, Montpellier, France.Department of Pneumology, Rouen University Hospital, France.CF centre, Hopital Jean Minjoz, Besançon, France.CF centre, Hôpital d' Angers, France.Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paediatric Gastroenterology and Respiratory Department, CF Centre, Université Paris 7, France.Department of Pneumology, Rouen University Hospital, France.Adult CF centre, Hospices Civils de Lyon, Groupe hospitalier Sud, Université de Lyon, France.CF centre, Hôpital d'enfants du Bocage, Dijon, France.CF centre, Hopital Pellegrin CIC 005, CHU Bordeaux, France.Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Paediatric Gastroenterology and Respiratory Department, CF Centre, Université Paris 7, France.CF centre, Hôpital d' Angers, France.CF centre, Hôpital de Clocheville, Tours, France.CF centre, Hôpital Foch, Suresnes, France.CF centre, Hôpital Robert Bisson, Lisieux, France.CF centre, Hôpital d'enfants du Bocage, Dijon, France.Assistance publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, CF centre, University Paris 5, France.CF centre, Hôpital Larrey, Toulouse, France.CF centre, Centre Perharidy, Roscoff, France.CF centre, Hôpital de Lens, France.Assistance publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, CF centre, University Paris 5, France.CF centre, Hôpital Bretonneau, Tours, France.Hospices Civils de Lyon, Hopital Femme-Mère-Enfant, CF centre, Bron, France.CF centre, Hôpital de Hautepierre, Strasbourg, France.Assistance publique-Hôpitaux de Paris, Hôpital Robert Debré, Biological Hematology Department, Université Paris 7, France.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25107684

Citation

Munck, Anne, et al. "Central Venous Thrombosis and Thrombophilia in Cystic Fibrosis: a Prospective Study." Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, vol. 14, no. 1, 2015, pp. 97-103.
Munck A, Kheniche A, Alberti C, et al. Central venous thrombosis and thrombophilia in cystic fibrosis: A prospective study. J Cyst Fibros. 2015;14(1):97-103.
Munck, A., Kheniche, A., Alberti, C., Hubert, D., Martine, R. G., Nove-Josserand, R., ... Hurtaud, M. F. (2015). Central venous thrombosis and thrombophilia in cystic fibrosis: A prospective study. Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society, 14(1), pp. 97-103. doi:10.1016/j.jcf.2014.05.015.
Munck A, et al. Central Venous Thrombosis and Thrombophilia in Cystic Fibrosis: a Prospective Study. J Cyst Fibros. 2015;14(1):97-103. PubMed PMID: 25107684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Central venous thrombosis and thrombophilia in cystic fibrosis: A prospective study. AU - Munck,Anne, AU - Kheniche,Ahmed, AU - Alberti,Corinne, AU - Hubert,Dominique, AU - Martine,Reynaud-Gaubert, AU - Nove-Josserand,Raphaele, AU - Pin,Isabelle, AU - Bremont,Francois, AU - Chiron,Raphael, AU - Couderc,Laure, AU - Dalphin,Marie Laure, AU - Darviot,Estelle, AU - Delaisi,Bertrand, AU - Dominique,Stéphane, AU - Durieu,Isabelle, AU - Fanton,Annelyse, AU - Fayon,Michael, AU - Gérardin,Michèle, AU - Giniès,Jean-Louis, AU - Giraut,Charlotte, AU - Grenet,Dominique, AU - Guillot,Marcel, AU - Huet,Frédéric, AU - Le Bourgeois,Muriel, AU - Murris-Epin,Marlène, AU - Ramel,Sophie, AU - Sardet,Anne, AU - Sermet-Gaudelus,Isabelle, AU - Varaigne,Françoise, AU - Wanin,Stéphanie, AU - Weiss,Laurence, AU - Hurtaud,Marie-Francoise, Y1 - 2014/08/05/ PY - 2014/03/14/received PY - 2014/05/20/revised PY - 2014/05/20/accepted PY - 2014/8/10/entrez PY - 2014/8/12/pubmed PY - 2015/11/3/medline KW - Cystic fibrosis KW - Thrombophilia KW - Thrombosis SP - 97 EP - 103 JF - Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society JO - J. Cyst. Fibros. VL - 14 IS - 1 N2 - BACKGROUND AND AIMS: Catheter venous thrombosis may result in life-threatening embolic complications. Recently, a thrombophilic tendency was described in cystic fibrosis (CF), the significance of which remains unclear. The aims of this study were to (1) document the frequency of catheter venous thrombosis detected by colour-Doppler-ultrasound (Doppler-US), (2) assess genetic and acquired thrombophilia risk factors for catheter venous thrombosis and hypercoagulability status and (3) provide recommendations on laboratory screening when considering insertion of a totally implantable vascular access device (TIVAD) in CF patients. METHODS: We designed a multicentre prospective study in patients selected at the time of catheter insertion. Doppler-US was scheduled at 1 and 6months after insertion and before insertion in case of a previous central line. Blood samplings were drawn at insertion and at 1 and 6months later. RESULTS: One-hundred patients received a TIVAD and 90 completed the 6-month study. Prevalence of thrombophilia abnormalities and hypercoagulability was found in 50% of the cohorts. Conversely, catheter venous thrombosis frequency was low (6.6%). CONCLUSION: Our data do not support biological screening at the time of a TIVAD insertion. We emphasise the contribution of a medical history of venous thromboembolism and prospective Doppler-US for identifying asymptomatic catheter venous thrombosis to select patients who may benefit from biological screening and possible anticoagulant therapy. SN - 1873-5010 UR - https://www.unboundmedicine.com/medline/citation/25107684/Central_venous_thrombosis_and_thrombophilia_in_cystic_fibrosis:_A_prospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1569-1993(14)00121-0 DB - PRIME DP - Unbound Medicine ER -