PREVENTION OF CENTRAL VENOUS CATHETER-ASSOCIATED THROMBOSIS USING MINIDOSE WARFARIN IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

Thrombosis is a well-recognized complication following insertion of ce ntral venous catheters and is associated with significant morbidity. I n an attempt to reduce line-associated thrombosis. 108 consecutive pat ients with haematological malignancies were commenced on prophylactic 'minidose' warfarin. 1 mg/d, at the time of line insertion. This group of patients were compared with a historic group of 115 consecutive pa tients who had not received warfarin. Clinically-suspected venous thro mbosis was confirmed by Doppler ultrasound or venography. Patients tak ing prophylactic warfarin had their prothrombin time measured three ti mes per week with the aim of maintaining an INR < 1.6. Five (5%) of th e 108 patients who received minidose warfarin developed a thrombosis, at a median of 72 d (range 5-166) from the time of catheter insertion. In the 115 patients who were not anticoagulated 15 (13%) developed a catheter-associated thrombosis at a median of 16 d (range 1-35). There was a significant reduction in line-associated thrombosis in patients receiving warfarin (P = 0.03). These data suggest that minidose warfa rin reduces the incidence of central venous catheter related thrombosi s in patients with haematological malignancies.