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

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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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Authors and Affiliations

  1. Interdisciplinary Research Laboratory Applied to Clinical Practice in Oncology, University of Brasília, Brasília, Brazil

    Ana Cristina Carvalho da Costa, Jéssica Marques Ribeiro, Christiane Inocêncio Vasques & Paula Elaine Diniz dos Reis

  2. Brazilian Center of Evidence-based Research, Federal University of Santa Catarina, Florianópolis, Brazil

    Graziela De Luca Canto & André Luís Porporatti

Authors
  1. Ana Cristina Carvalho da Costa
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  2. Jéssica Marques Ribeiro
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Correspondence to Ana Cristina Carvalho da Costa.

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The authors declare that they have no conflict of interest.

We declare that we have had full control of the primary data extracted for this study, and we agree to allow the journal to revise the data, if it will be requested.

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da Costa, A.C.C., Ribeiro, J.M., Vasques, C.I. et al. Interventions to obstructive long-term central venous catheter in cancer patients: a meta-analysis. Support Care Cancer 27, 407–421 (2019). https://doi.org/10.1007/s00520-018-4500-y

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