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Leiden Factor 5 Mutation

Have a pt. with thrombosis rt. IJ into sublclavian from IJ catheter. Lt. arm thrombosis basilic going into sublclavian.  Pt. also had a VAD implanted that clotted.  30 year old being treated for ongoing problems with migraines. Placing midline as we are unable to get any other access.  Pt. will not be getting any vesicants through this line.  Pt. also has a clotting disorder.  Md wonders if anyone else has seen similiar pt's and what they did for access.  On anticoagulants and he is going to bump up her INR's.