Critical Review of International Clinical Practice Guidelines Recommendations for Prevention, Diagnosis, and Management of Central Venous Catheter Thrombosis

Abstract

Central venous catheters (CVCs) are widely used in clinical practice for the administration of medications, parenteral nutrition, and hemodynamic monitoring. However, their use is associated with a significant risk of thrombosis, which can lead to serious complications, including catheter dysfunction, infection, and embolism. Numerous international clinical practice guidelines (CPGs) have been developed to address the prevention, diagnosis, and management of CVC-related thrombosis. This critical review aims to evaluate and compare the recommendations provided by these guidelines, highlighting areas of consensus, variation, and potential gaps. We systematically analyzed CPGs from major healthcare organizations, focusing on key aspects such as risk stratification, prophylactic strategies, diagnostic algorithms, and therapeutic interventions. Although most guidelines emphasize the importance of risk assessment and early intervention, there are notable discrepancies in recommendations regarding the use of anticoagulant prophylaxis, imaging modalities for diagnosis, and the duration of anticoagulation therapy. Additionally, the review explores the evidence underpinning these recommendations and identifies areas where robust clinical data are lacking. Our analysis underscores the need for harmonization across guidelines to ensure consistent and evidence-based care. Furthermore, we advocate for the development of multidisciplinary approaches to enhance decision-making and optimize clinical outcomes in this domain. By addressing the gaps and inconsistencies in current CPGs, this review seeks to provide a framework for improving the prevention, diagnosis, and management of CVC-related thrombosis, ultimately enhancing patient outcomes and reducing the healthcare burden.

Keywords

venous thromboembolism - coagulation - anticoagulation - thrombophilia - cancer

Publication History

Received: 21 January 2025

Accepted: 04 July 2025

Accepted Manuscript online:
07 July 2025

Article published online:
24 July 2025

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