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Catheter-related DVT — SCE Medical Oncology MCQ

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ModerateOncological EmergenciesCatheter-related DVTSCE Medical Oncology

A 62-year-old woman with cancer develops a new acute painful red swollen leg. She is on chemotherapy and has a PICC line in the ipsilateral arm. Doppler confirms an upper limb DVT at the PICC line site. What is the management?

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Correct answer: A — Anticoagulation ± PICC line removal

Catheter-related upper limb DVT (CR-UEDVT) is common in cancer patients with central venous catheters. Management differs from lower limb DVT: anticoagulation should be started (LMWH or DOAC). The catheter can be retained if functional and needed, provided anticoagulation is therapeutic and there is no infection, severe symptoms or progression. Anticoagulation should continue for ≥3 months and as long as the catheter remains in situ. Routine catheter removal is not necessary if thrombosis responds to anticoagulation.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer