Incidence and Clinical Progression of Asymptomatic PICC-Related Thrombosis in Solid Neoplasm Patients: Ultrasound Insights from a Prospective Cohort Study

Background Managing central venous catheters in patients with neoplasms is challenging, and peripherally inserted central catheter-port has emerged as a promising option for safety and efficacy. However, understanding the clinical progression of catheter-related thrombosis in cancer patients with central venous catheters remains limited, especially in certain neoplasm types associated with a higher risk of venous thrombosis. Methods In this prospective cohort study of 120 patients with solid neoplasms receiving chemotherapy, we investigated the incidence of isolated upper extremity superficial vein thrombosis, upper extremity deep vein thrombosis, and fibrin sheath formation through ultrasound follow-up at 30 and 90 days after catheter insertion. We analyzed risk factors associated with catheter-related thrombosis (CRT) and compared incidence rates between PICC-PORT and traditional PICC. Results Among the cohort, 69 patients (57.5%) had high-risk thromboembolic neoplasm, and 31 cases (25.8%) of CRT were observed, mostly within 30 days, with only 7 cases (22.6%) showing symptoms. Traditional PICC use (OR 5.86; 95% CI 1.14-30) and high-risk thromboembolic neoplasm (OR 4.46; 95% CI 1.26-15.81) were identified as independent risk factors for catheter-related thrombosis. Conclusions The majority of CRT present asymptomatically within the first 30 days of venous catheter insertion in patients with solid neoplasms. Ultrasound follow-up is valuable for detecting asymptomatic CRT. The risk of CRT was lower with PICC-PORT than with PICC. Additionally, the risk of CRT was found to be higher in patients with high-risk thromboembolic neoplasms. It is crucially important for larger studies to confirm the utility of treating asymptomatic thromboses and isolated superficial thrombosis.