How would you manage an incidental catheter-related thrombosis in a functioning dialysis catheter?

Topics: Medical Oncology • Thrombosis • Hematology • Benign Hematology • Hemostasis/Thrombosis • Nephrology

- Dialysis catheter used for hemodialysis
- RIJ thrombus in dialysis catheter was incidentally found
- Patient asymptomatic with no prior history of VTE or cancer

Answer from: at Community Practice

If the patient is asymptomatic and the catheter is functioning well, I recommend starting anticoagulation.If the patient develops symptoms, he or she should still be anticoagulated but the catheter removed. Anticoagulation options in ESRD patients include Coumadin, Eliquis (my preference is a d...

Comments

Medical Oncologist at Locum Tenens
I agree. I would also forgo the "induction" dose o...

Answer from: at Community Practice

I agree that if safe and there are no contraindications to anticoagulation, that anticoagulation should be started. It is important to note that dialysis patients have an inherently higher risk of bleeding compared to the usual population, so the risks and benefits of anticoagulation should be weigh...

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