Catheter-related venous thrombosis at home parenteral nutrition: From prevention to treatment

The objective of this review is to summarize the literature and to look at epidemiology, prevention and treatment of catheter-associated venous thrombosis in home parenteral nutrition patients. The rate of this complication is between 0.01 to 0.03 episodes per catheter year. Several risk factors have been identified, such as the position of the catheter tip, the type of material used and a history of catheter-associated infections. Systematic anticoagulant prophylaxis has largely been ineffective. Good insertion technique and catheter cares remain important preventives measures. Moreover, the optimal anticoagulant treatment is unclear due to lack of well-designed studies. In case of catheter-associated venous thrombosis in home parenteral nutrition patients, removal of the catheter is not mandatory. If it is functional, necessary and without associated infection, long-term systemic anticoagulation will be indicated. (C) 2013 Elsevier Masson SAS. All rights reserved.