Authors: Felicitas Hitz Dirk Klingbiel Aurelius Omlin Salomé Riniker Andreas Zerz Thomas Cerny
Publish Date: 2011/09/29
Volume: 91, Issue: 4, Pages: 613-620
Abstract
Cancer patients with longterm venous catheter are at risk for thromboembolic complications at the catheter tip and in the adjacent venous vessels We assessed whether local thrombogenicity could be prevented with an experimental coated with athrombogenic layer catheter device CD compared to an uncoated CD Patients requiring a longterm venous catheter were randomly allocated to receive either a standard uncoated or experimental coated with athrombogenic Camouflage® layer CD The athrombogenic layer creates a barrier against nonspecific adsorption of plasma proteins The primary endpoint was urokinase injection in cases of an unsuccessful blood aspiration from the CD Secondary endpoints included early haematoma pneumothorax and late venous thrombosis infection catheterassociated complications and catheter defects One hundred and seventynine patients were randomly assigned to a CD experimental n = 89/standard n = 90 One hundred and ten 62 patients with a total of 1286 catheter taps were analysed for the primary endpoint Necessity for urokinase injection was 8/680 12 experimental vs 33/606 54 standard per catheter tap and 4/55 73 experimental vs 18/55 327 standard per patient A repeated measures logistic regression to assess the effect of coating yielded an odds ratio of 35 95 confidence interval 12–104 p = 003 for the primary endpoint All patients allocated per protocol were analysed for the secondary endpoints Nine 54 local thrombotic complications seven 41 catheter infections and no catheter defect were observed Athrombogenic coating of CD in cancer patients resulted in a significant reduced necessity for urokinase injections and subsequently less inconvenience for patients and fewer costly interventions
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