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01-02-2019 | Review Article

Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis

Authors: Ana Cristina Carvalho da Costa, Jéssica Marques Ribeiro, Christiane Inocêncio Vasques, Graziela De Luca Canto, André Luís Porporatti, Paula Elaine Diniz dos Reis

Published in: Supportive Care in Cancer | Issue 2/2019

Abstract

Purpose

The aim of this systematic review was to identify the interventions used to treat obstructive events, whether thrombotic or non-thrombotic, in long-term central venous catheters (LT-CVC) in cancer patients.

Methods

This review included clinical trials and observational studies reporting the drugs used to treat obstructive catheter events in cancer patients. The authors developed specific search strategies for CINAHL, Cochrane CENTRAL, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest. The authors evaluated methodological quality of included studies using criteria from Cochrane’s Collaboration Tool and the Methodological Index for non-randomized studies (MINORS). The quality of evidence was analyzed by using GRADE’s software.

Results

More than 9000 articles were found across the databases. After duplicates removed, the studies were selected in 2 phases. After that, only 15 studies were included. The drugs used to restoration of catheter function were urokinase (53.3%), alteplase (20%), tenecteplase (13.3%), reteplase (6.7%), recombinant urokinase (6.7%), and staphylokinase (6.7%). The results of meta-analysis of 14 studies showed an overall restoration rate of ~ 84%. The drug type meta-analysis demonstrates a success rate of ~ 84%, ~ 92%, and ~ 84% for urokinase, alteplase, and tenecteplase groups, respectively. The main methodological problem in included articles concerns the sample. The quality of evidence ranged from very low to high.

Conclusion

The most common interventions used to treat thrombotic catheter occlusion in cancer patients were urokinase and alteplase. No evidence was found about the treatment for non-thrombotic occlusion, thus elucidating an important gap to be investigated.

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Title: Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis
Authors: Ana Cristina Carvalho da Costa
Jéssica Marques Ribeiro
Christiane Inocêncio Vasques
Graziela De Luca Canto
André Luís Porporatti
Paula Elaine Diniz dos Reis
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 2/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4500-y

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