Management of catheter-related septic thrombosis - 01/11/25
, Hélène Chaussade a, Claire Rivoisy a, Anne Contis a, Marie-Anne Vandenhende b, Didier Bronnimann a, Juliette Prola a, Céline Delassasseigne c, Gaël Galli a, d, Joël Constans e, Fabrice Bonnet a, fHighlights |
• | The management of catheter-related septic thrombosis remains heterogeneous, largely due to the reliance on low-level evidence in current guidelines. |
• | In our survey, which aimed to characterize French clinical practices on this topic, we found that systematic screening for thrombosis is not routinely performed. |
• | However, imaging is typically conducted in the presence of local inflammatory signs or when antimicrobial therapy fails. |
• | Antimicrobial treatment lasting ≤ 21 days is commonly prescribed, and curative anticoagulation is frequently administered in cases of deep vein thrombosis, although further robust studies are needed to confirm its benefit. |
Abstract |
Introduction |
The use of intravascular catheters is associated with a risk of catheter-related septic thrombosis (CRST), which management remains highly variable due to a lack of robust scientific evidence. This study aimed to describe current practices in France through a systematic survey.
Methods |
A web-based survey was disseminated via 10 French medical societies between June and October 2024.
Results |
Among 156 respondents, 69 were infectious disease specialists. For catheter-related bloodstream infections, ultrasound imaging is not routinely performed by 60 % of respondents but is typically performed in the presence of local inflammatory signs or antimicrobial therapy (AMT) failure. Over 60 % of respondents reported prescribing AMT for ≤ 21 days. In cases of CRST involving a deep vein (DV), more than 80 % of respondents considered the use of curative anticoagulation. For proximal DV CRST, 126 of 156 (81 %) respondents performed follow-up ultrasound imaging to assess venous repermeabilization. The most frequently cited research priorities included the need for and appropriate use of anticoagulation (n = 71/156; 46 %), as well as AMT optimal duration (n = 47/156; 30 %).
Conclusion |
Despite the heterogeneity in clinical practice, our findings highlight a prevailing trend toward prescribing AMT for ≤ 21 days and the use of curative anticoagulation in cases of DV thrombosis. However, these approaches require further investigation through well-designed studies to establish their benefit.
Le texte complet de cet article est disponible en PDF.Keywords : Catheter, Catheter-related thrombosis, Catheter-related infection, Suppurative thrombophlebitis, Anticoagulation
Plan
Vol 55 - N° 7
Article 105119- novembre 2025 Retour au numéro
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