{"id":5550,"date":"2023-09-04T11:00:11","date_gmt":"2023-09-04T09:00:11","guid":{"rendered":"https:\/\/eu.bd.com\/iv-news\/?p=5550"},"modified":"2025-06-04T14:24:10","modified_gmt":"2025-06-04T12:24:10","slug":"how-to-identify-and-reduce-the-risk-of-catheter-related-thrombosis","status":"publish","type":"post","link":"https:\/\/eu.bd.com\/iv-news\/events-training\/how-to-identify-and-reduce-the-risk-of-catheter-related-thrombosis\/","title":{"rendered":"How to identify and reduce the risk of catheter-related thrombosis"},"content":{"rendered":"

Catheter-related thrombosis is reported as one of the most common complications following central venous access insertion.<\/span>1<\/span><\/sup>\u00a0<\/span>\u00a0<\/span><\/p>\n

Although it has been widely studied and discussed, there still exists some confusion around catheter technologies, insertion techniques and management bundles.<\/span>1,2<\/span><\/sup>\u00a0<\/span><\/p>\n

Dr Fulvio Pinelli, Director of the Vascular Access Centre at the Careggi University Hospital in Florence, Italy, presented on this topic at the BD Multidisciplinary Advanced Course on Vascular Access (MACOVA) 2022.<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

Catheter-related thrombosis, occlusion or fibroblastic sleeve?<\/h2>\n

\u201cWhen we talk about thrombosis,\u201d said Dr Pinelli. \u201cWe have to be clear on the definition.\u201d<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

In fact, he noted that much of the published literature still appears confused on the differences between catheter-related thrombosis, occlusion and fibroblastic sleeves.<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

Dr Pinelli characterised occlusion as a condition of the internal catheter lumen, determined by an intraluminal clot.<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

In the last 50 years, fibroblastic sleeves have been given various names, including fibrin sleeves, fibrin sheaths, catheter sleeves or catheter-related sleeve.<\/span>2<\/span><\/sup> While the terms \u201csleeve\u201d and \u201csheath\u201d may be correct, said Dr Pinelli, \u201cfibrin\u201d certainly is not, since a fibroblastic sleeve is composed of connective tissue with its main non-cellular component being collagen, not fibrin.<\/span>2 <\/span><\/sup>As a foreign body reaction, fibroblastic sleeves are harmless and typically require no treatment.<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

Dr Pinelli presented evidence of the three main factors that determine thrombosis and how it differs from other conditions, a system coined by Berlin Pathologist Rudolf Virchow known as \u201cVirchow’s Triade:\u201d<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

    \n
  1. Endothelial damage: <\/span><\/b>Catheter insertion<\/span>\u00a0<\/span><\/li>\n
  2. Blood stasis:<\/span><\/b> Presence of catheter itself, infusion fluids, immobilisation<\/span>\u00a0<\/span><\/li>\n
  3. Hypercoagulability:<\/span><\/b> Sepsis, malignancies, inflammation, thrombophilia<\/span>\u00a0<\/span><\/li>\n<\/ol>\n

    \u201cWe can’t do much on hypercoagulability, it’s a condition of the patient,\u201d said Dr Pinelli. \u201cBut we can do something, even if not everything, for endothelial damage and blood stasis.\u201d<\/span>2<\/span><\/sup>\u00a0<\/span><\/p>\n

    More on this topic: <\/span><\/b>Thrombosis<\/a><\/p>\n\t\t\t\t\t

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