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Central Venous Thrombosis Related to the Silastic Hickman-Broviac Catheter in an Oncologic Population

Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California

Lawrence D. Wagman, M.D.

Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California

Daniel U. Rhimaki, M.D.

Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California

Jose J. Terz, M.D.

Department of General Oncologic Surgery, City of Hope National Medical Center, Duarte, California

The use of subcutaneously implanted, Dacron cuffed, central venous silastic catheters (Hickman/Broviac catheter [HC/BC]) has not eliminated catheter related-central venous thrombosis (CR-CVT). HC/BC related CR-CVT was identified and followed in 15 oncology patients. Median time period to CR-CVT was 155 days (range 15-638). No correlation was established to patient age, sex, diagnosis, coagulation status, use, longevity, technique, or site of placement. Fourteen patients were treated with anticoagulation and/or thrombolytic therapy. Of seven patients treated with HC/BC in situ, one required HC/BC removal to achieve CR-CVT resolution. Median follow-up post-CR-CVT was 362 days (range 34-1622). No patient suffered untoward long-term sequelae. Nine patients had 11 catheters placed following resolution of CR-CVT. None had repeat thrombosis. CR-CVT incidence in a single 12-month period was 3.7% (7/190). The placement of HC/BC in an oncology population is an acceptably safe method for long-term venous access. (Journal of Parenteral and Enteral Nutrition 13:397-400, 1989)

Journal of Parenteral and Enteral Nutrition, Vol. 13, No. 4, 397-400 (1989)
DOI: 10.1177/0148607189013004397


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