What should be considered before central venous line placement in patients with antithrombin III (ATIII) deficiency?

Updated: Feb 10, 2018
  • Author: James L Harper, MD; Chief Editor: Hassan M Yaish, MD  more...
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Answer

Take care to determine whether risks of a given vascularly invasive procedure (ie, central venous line [CVL] placement) outweigh increased risk of thrombosis.

Any foreign body stimulates clot formation, and the risk of an occlusive clot significantly increases if the size of the foreign body is such that laminar flow through the vessel is disturbed. For example, neonates commonly have venous obstruction due to central lines, which leads to disturbance of flow in the vein and the development of small vessels that bypass the obstructed vein. The vein becomes obstructed due to the presence of the central line. If an indwelling catheter is needed in a patient at high risk for thrombosis, it should be a small flexible catheter and should remain in only as long as is absolutely necessary. Consider using peripheral intravenous lines or peripherally inserted central catheter (PICC) lines rather than large bore central lines when practical.


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