The Catheter Study: Central Venous Catheter Survival in Cancer Patients Using Low Molecular Weight Heparin (Dalteparin) for the Treatment of Deep Vein Thrombosis

The purpose of this study is to obtain an estimate of catheter survival in the setting of upper extremity deep vein thrombosis (UEDVT) in patients treated with dalteparin and warfarin. Anticoagulation with dalteparin and warfarin in patients with UEDVT secondary to central venous catheters in patients with an active malignancy is an effective therapy as quantified by the success of catheter preservation. A prolonged line salvage rate without a recurrence of UEDVT will improve the management of cancer patients who develop upper extremity deep venous thrombosis in the setting of a central venous (CV) catheter.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Males or females greater than or equal to 18 years of age, inclusive.
* Symptomatic acute upper limb thrombosis with or without pulmonary embolism associated with central venous catheter objectively documented by compression ultrasonography, venogram or computed tomography (CT) scan.
* Diagnosis of active malignancy, as defined by patients who are either receiving active treatment, or have metastatic disease or who have been diagnosed within the past two years.
* Willing to provide written informed consent.

Exclusion Criteria:

* Dialysis catheters.
* Active bleeding or high risk for major bleeding.
* Platelet count \< 100 x 10x9/L.
* Serum creatinine \> 177umol/L
* Currently on warfarin with therapeutic intent (does not include minidose warfarin used as prophylaxis for CV catheter thrombosis).
* Pulmonary embolism accompanied by hemodynamic instability or oxygen requirement.
* Inability to infuse through the catheter after a trial of intraluminal thrombolytic therapy.
* Patients with acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL) with a bone marrow or stem cell transplant pending in next 3 months.

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