Right heart thrombus in transit and peripherally inserted central catheters

Thrombosis Journal

Case Report

Anastasis Sioftanos¹  Amit K J Mandal²  Rezwan N Hussain²  Jihène El Kafsi³  Nick Li⁴  Constantinos G Missouris⁵ 

[1] University of Nicosia Medical School, Nicosia, Cyprus;Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK;Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK;Ashford and St Peter’s NHS Foundation Trust, Chertsey, UK;Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK;The Queen’s College, University of Oxford, Oxford, UK;Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK;University of Nicosia Medical School, Nicosia, Cyprus;

关键词: Right heart thrombus;    Peripherally inserted central catheters;    PICC;    Thrombosis;    Risks;    Imaging;    Anticoagulation;   

DOI  :  10.1186/s12959-023-00513-3

 received in 2023-03-14, accepted in 2023-06-11,  发布年份 2023

来源: Springer

【 摘 要 】

Right heart thrombus in transit or “free-floating right heart thrombus” is defined as thrombus(i) arising from the deep veins that embolises to the right atrium or right ventricle before reaching the pulmonary vasculature. It is almost always associated with pulmonary thromboembolism and is a medical emergency with reported mortality rates of over 40%. We present two cases of right heart thrombus in transit with pulmonary thromboembolism resulting from venous thrombosis associated with peripherally inserted central catheters that were managed with different approaches. The cases highlight that clinicians should have a low threshold to utilise imaging modalities such as computerised tomography and transthoracic echocardiography when there is an untoward change in physiological parameters among patients with peripherally inserted central catheters, particularly those with risk factors for peripherally inserted central catheter associated venous thrombosis. Furthermore, procedural optimisation surrounding peripherally inserted central catheters, such as insertion technique and choice of lumen size, is underscored.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2023_37_Article_IEq236.gif

Fig. 5

Fig. 3

41116_2023_37_Article_IEq181.gif