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Online ISSN 1827-1596
Iervese G. 1, Spina T. 1, Mascitelli G. 1, Acquarola P. 2, Orlandi P. 2, Bosco G. 1
1 Servizio di Anestesia e Rianimazione Ospedale Civile «S. Spirito», Pescara
2 Scuola di Specializzazione in Anestesia e Rianimazione Università degli Studi «G. D’Annunzio», Chieti
Oncologic diseases frequently need a central venous catheterization to improve pharmacological administration safety and patient’s comfort. We report a case of a woman affected by acute myelocytic leukemia with a bilateral stenosis of the innominate veins, likely of thrombotic nature, diagnosed during central venous catheterization. These events, as that occurred to our patient, are usually caused by hypercoagulability inducted by oncologic diseases, sepsis, antithrombin III deficiency, catheters materials and repeated catheterizations. Although the treatment, based on local thrombolysis, systemic heparinization, and surgery to repair venous obstruction, is effective, the prevention of such events is fundamental. It can be achieved with catheters of particular characteristics and appropriate management techniques. Finally it is underlined that in oncology patients, before catheterization, especially when the objective examination is negative, radiological methodologies and in particular ultrasonography are an important aid to establish the presence or absence of thrombosis in internal jugular, subclavian and innominate veins.