had a breast cancer patient receiving FEC chemotherapy who developed a thrombosis in her PICC arm on day 9 after insertion. It went up through subclavia and stopped near the juglar vein. Although asymptomatic for PE, a CT scan was performed and PE was diagnosed. The PICC was kept in place and the patient placed on Fragmin 12500 IE/day. Resolution of symptoms was fast and a month later the thrombosis could not be seen on ultrasound. The line was kept for about 10 weeks and pulled after completion of chemotherapy. If anyone has views on how this was handled, I would be most interested. Do you keep your PICCs when thrombosis occurs?
Although my main question is this: At diagnosis of thrombosis a coagulation consultant was consulted, who said that the PICC line could be kept if Fragmin was started, but it could be not used for the chemoptherapy course a few days after diagnosis of the thrombosis. A PIV had to be placed and used for that course of treatment. The PICC was then used for the remaining three courses. There was never any malfunction of the PICC. Does anyone see the reason in not using the PICC that one treatment?
Mats in Stockholm