Clinical Observation of Upper-extremity Deep Vein Thrombosis after Central Venous Catheterization via the Axillary Vein

Objective To determine the frequency of central venous catheter-induced thrombosis of the axillary vein.Methods Sixty patients in a medical-surgical intensive care unit who required central venous catheterization via the axillary vein from January 2007to December 2009 were selected.On catheter removal,color doppler ultrasonography examination was performed on all the patient.The incidence of deep vein thrombosis in catheterized arms was compared with that in uncatheterized arms.This study was designed by prospective controlled study.Results Catheters were inserted for a mean duration of(14.7±7.4)days.Sixty patients who underwent axillary vein cannulation,one patient had clinical signs of arm vein thrombosis,and no patient had clinical sign of pulmonary embolism.Fibrin sleeves that developed around the catheters were observed in 28patients(47%).Five patients(8.3%)had phlebographic signs of partial axillary vein thrombosis:nonobstructive clots adherent to the vessel wall and(or)the catheter.Two patients(3.3%)had color doppler ultrasonography signs of complete axillary vein thrombosis.No thrombosis was observed in patients with catheterizations lasting≤6days,two cases were observed for duration of 7-14days,and five cases were observed for duration of≥15days(P0.01).In seven patients with axillary vein thrombosis,the vessel was cannulated with fewer than three puncture attempts,and the mean duration for catheter insertion(10±2.5)minutes didn't differ much from that of patients with no axillary vein thrombosis(14±9)minutes.Conclusion The axillary vein catheterization is associated with 11.6%frequency of upper-extremity deep vein thrombosis.