{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:00:22Z","timestamp":1789639222030,"version":"4.0.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Central venous catheters (CVCs) represent one of the main risk factors for venous thrombotic events (VTEs) in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied the Italian Registry of Pediatric Thrombosis (RITI) with regard to systemic radiologically confirmed CVC-related VTEs (CVC-VTEs) occurred during 6.5 years in children aged 29 days to 18 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 78 CVC-VTEs were included, which occurred in 76 patients (40\/76, 53% males). CVC-VTEs comprised 67 non-cardiac VTEs (86%) and 11 intracardiac thrombotic events (ICTEs) (14%); the median age at onset was 19 and 17 months, respectively. The most frequent reason for CVC insertion was supportive therapy. The catheters were placed percutaneously in 85% of cases (56\/66) and surgically in the remaining 15% (10\/66). Peripherally inserted central catheters (PICCs) were used in 47% (31\/66) cases, partially implanted catheters in 42% (28\/66), non-implantable catheters in 7% (5\/66), and totally implanted catheters (Port) in 2% (1\/66). CVC-VTEs were symptomatic in 77% of cases (60\/78), while in the remaining 23%, they were incidentally detected on the imaging performed for the underlying condition. The median time between CVC insertion and the onset of symptoms was 10 days in non-cardiac VTEs and 39 days in ICTEs. Doppler ultrasound was the diagnostic technique most frequently used. The venous compartment most frequently affected was the veins of the lower extremities (52%, 43\/73). Anti-thrombotic treatment was administered in 96% of CVC-VTEs (75\/78). About 2.6% (2\/76) of patients experienced a second thrombotic event. At discharge, post-thrombotic syndrome was reported in 13.5% (5\/37) events with available data, CVC replacement in 10.8% (4\/47), and ischemic necrosis with toe finger amputation in 2.7% (1\/37). Three patients died due to an underlying condition; no CVC-VTE-related deaths were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have carried out a registry-based study on CVC-VTEs in the children in Italy, providing the data that may help improve the detection and management of this CVC-related complication.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.843643","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T09:31:51Z","timestamp":1674034311000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Systemic Catheter-Related Venous Thromboembolism in Children: Data From the Italian Registry of Pediatric Thrombosis"],"prefix":"10.3389","volume":"10","author":[{"given":"Donatella","family":"Lasagni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Nosadini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Claudio","family":"Molinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Saracco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Federica","family":"Pelizza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiammetta","family":"Piersigilli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Caterina","family":"Putti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Gaffuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Lorenzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Francavilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Trapani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Luciani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Suppiej","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Tufano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Tormene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Martinato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Gregori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Sartori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Systemic Thromboses Working Group of the Italian Registry of Pediatric Thrombosis (RITI Registro Italiano Trombosi Infantili)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.thromres.2020.01.017","article-title":"Central venous catheter-related thrombosis in children and adults","volume":"187","author":"Citla Sridhar","year":"2020","journal-title":"Thromb Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S0140-6736(09)60220-8","article-title":"Management of occlusion and thrombosis associated with long-term indwelling central venous catheters","volume":"374","author":"Baskin","year":"2009","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.3324\/haematol.2015.123455","article-title":"Hospital-associated venous thromboembolism in pediatrics: a systematic review and meta-analysis of risk factors and risk-assessment models","volume":"100","author":"Mahajerin","year":"2015","journal-title":"Haematologica."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1182\/blood.V83.5.1251.1251","article-title":"Venous thromboembolic complications (VTE) in children: first analyses of the Canadian registry of VTE","volume":"83","author":"Andrew","year":"1994","journal-title":"Blood."},{"key":"B5","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1016\/j.jpeds.2013.10.025","article-title":"Hospital-associated venous thromboembolism in children: incidence and clinical characteristics","volume":"164","author":"Takemoto","year":"2014","journal-title":"J Pediatr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"3292","DOI":"10.1182\/bloodadvances.2018024786","article-title":"American society of hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism","volume":"2","author":"Monagle","year":"2018","journal-title":"Blood Adv."},{"key":"B7","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1111\/jth.12071","article-title":"International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer","volume":"11","author":"Debourdeau","year":"2013","journal-title":"J Thromb Haemost."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1952","DOI":"10.3324\/haematol.2010.026989","article-title":"Post-thrombotic syndrome in children: a systematic review of frequency of occurrence, validity of outcome measures, and prognostic factors","volume":"95","author":"Goldenberg","year":"2010","journal-title":"Haematologica."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1046\/j.1538-7836.2003.00308.x","article-title":"Venous thrombosis in children","volume":"1","author":"Chan","year":"2003","journal-title":"J Thromb Haemost."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1007\/s00277-015-2481-1","article-title":"Recommendations for the use of long-term central venous catheter (CVC) in children with hemato-oncological disorders: management of CVC-related occlusion and CVC-related thrombosis. on behalf of the coagulation defects working group and the supportive therapy working group of the Italian association of pediatric hematology and oncology (AIEOP)","volume":"94","author":"Giordano","year":"2015","journal-title":"Ann Hematol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1203\/00006450-200006000-00013","article-title":"Outcome of pediatric thromboembolic disease: a report from the Canadian childhood thrombophilia registry","volume":"47","author":"Monagle","year":"2000","journal-title":"Pediatr Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1067\/mpd.2001.118192","article-title":"Venous thromboembolism in childhood: a prospective two-year registry in The Netherlands","volume":"139","author":"van Ommen","year":"2001","journal-title":"J Pediatr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.beha.2012.07.001","article-title":"Venous thromboembolism in neonates and children","volume":"25","author":"Kenet","year":"2012","journal-title":"Best Pract Res Clin Haematol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1182\/blood.V80.8.1998.1998","article-title":"Maturation of the hemostatic system during childhood","volume":"80","author":"Andrew","year":"1992","journal-title":"Blood."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1160\/TH14-05-0431","article-title":"Paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis. first report from the Italian registry of pediatric thrombosis (R I T I, registro Italiano trombosi infantili)","volume":"113","author":"Suppiej","year":"2015","journal-title":"Thromb Haemost."},{"key":"B16","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.jpeds.2015.12.035","article-title":"Clinical data of neonatal systemic thrombosis","volume":"171","author":"Saracco","year":"2016","journal-title":"J Pediatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s00247-015-3467-9","article-title":"Diagnostic accuracy of point-of-care ultrasound for catheter-related thrombosis in children","volume":"46","author":"Li","year":"2016","journal-title":"Pediatr Radiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1542\/peds.2007-3852","article-title":"Incidence and diagnosis of thrombosis in children with short-term central venous lines of the upper venous system","volume":"122","author":"Hanslik","year":"2008","journal-title":"Pediatrics."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1160\/TH13-10-0827","article-title":"Epidemiology of venous thrombosis in children with cancer","volume":"111","author":"Piovesan","year":"2014","journal-title":"Thromb Haemost."},{"key":"B20","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.thromres.2005.01.010","article-title":"Epidemiology of venous thrombotic event in neonates and children","volume":"118","author":"Chalmers","year":"2006","journal-title":"Thromb Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1093\/annonc\/mdp052","article-title":"2008 SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: report from the working group","volume":"20","author":"Debourdeau","year":"2009","journal-title":"Ann Oncol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1111\/jth.12699","article-title":"No impact of endogenous prothrombotic conditions on the risk of central venous line-related thrombotic events in children: results of the KIDCAT study (KIDs with catheter associated thrombosis)","volume":"12","author":"Thom","year":"2014","journal-title":"J Thromb Haemost."},{"key":"B23","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.jpeds.2011.03.052","article-title":"Pediatric venous and arterial noncerebral thromboembolism in Denmark: a nationwide population-based study","volume":"159","author":"Tuckuviene","year":"2011","journal-title":"J Pediatr"},{"key":"B24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.thromres.2017.11.019","article-title":"A multi-institutional registry of pediatric hospital-acquired thrombosis cases: The Children's Hospital-Acquired Thrombosis (CHAT) project","volume":"161","author":"Jaffray","year":"2018","journal-title":"Thromb Res."},{"key":"B25","doi-asserted-by":"publisher","first-page":"632","DOI":"10.18433\/J34P4M","article-title":"Treatment and prophylaxis of catheter-related thromboembolic events in children","volume":"15","author":"Cortejoso","year":"2012","journal-title":"J Pharm Pharm Sci."},{"key":"B26","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12944-015-0005-6","article-title":"Modulation of endothelial cell integrity and inflammatory activation by commercial lipid emulsions","volume":"14","author":"Harvey","year":"2015","journal-title":"Lipids Health Dis."},{"key":"B27","doi-asserted-by":"publisher","first-page":"198","DOI":"10.3389\/fped.2017.00198","article-title":"Pediatric hospital acquired venous thromboembolism","volume":"5","author":"Witmer","year":"2017","journal-title":"Front Pediatr."},{"key":"B28","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1093\/annonc\/mdi111","article-title":"Central venous catheter-related complications in children with oncological\/hematological diseases: an observational study of 418 devices","volume":"16","author":"Fratino","year":"2005","journal-title":"Ann Oncol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1182\/asheducation-2008.1.228","article-title":"Thrombophilia in children: who to test how when and why?","author":"Raffini","year":"2008","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"B30","doi-asserted-by":"publisher","first-page":"4197","DOI":"10.1002\/cncr.25199","article-title":"Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer","volume":"116","author":"Revel-Vilk","year":"2010","journal-title":"Cancer"},{"key":"B31","doi-asserted-by":"publisher","first-page":"2712","DOI":"10.1182\/blood-2017-10-811216","article-title":"Can thrombophilia predict recurrent catheter-related deep vein thrombosis in children?","volume":"131","author":"Avila","year":"2018","journal-title":"Blood."},{"key":"B32","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3389\/fped.2017.00050","article-title":"Inherited thrombophilia in pediatric venous thromboembolic disease: why and who to test","volume":"5","author":"van Ommen","year":"2017","journal-title":"Front Pediatr."},{"key":"B33","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/j.thromres.2013.08.018","article-title":"Incidence of thrombosis in children with tunneled central venous access devices versus peripherally inserted central catheters (PICCs)","volume":"132","author":"Kanin","year":"2013","journal-title":"Thromb Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jpeds.2018.03.026","article-title":"Increased risk of thrombosis associated with peripherally inserted central catheters compared with conventional central venous catheters in children with leukemia","volume":"198","author":"Noailly Charny","year":"2018","journal-title":"J Pediatr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12959-017-0148-y","article-title":"The risk of venous thromboembolism associated with peripherally inserted central catheters in ambulant cancer patients","volume":"15","author":"Jones","year":"2017","journal-title":"Thromb J"},{"key":"B36","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/j.1538-7836.2010.04126.x","article-title":"Risk factors for catheter-related thrombosis (CRT) in cancer patients: a patient-level data (IPD) meta-analysis of clinical trials and prospective studies","volume":"9","author":"Saber","year":"2011","journal-title":"J Thromb Haemost."},{"key":"B37","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1160\/TH03-02-0091","article-title":"Significant association with location of central venous line placement and risk of venous thrombosis in children","volume":"94","author":"Male","year":"2005","journal-title":"Thromb Haemost."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1016\/j.jpedsurg.2012.03.043","article-title":"Characterization of central venous catheter-associated deep venous thrombosis in infants","volume":"47","author":"Gray","year":"2012","journal-title":"J Pediatr Surg"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1007\/s00247-018-4096-x","article-title":"Increased risk of symptomatic upper-extremity venous thrombosis with multiple peripherally inserted central catheter insertions in pediatric patients","volume":"48","author":"Gnannt","year":"2018","journal-title":"Pediatr Radiol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1111\/pan.12410","article-title":"Thrombotic complications in children from short-term percutaneous central venous catheters: what can we do?","volume":"24","author":"Latham","year":"2014","journal-title":"Paediatr Anaesth."},{"key":"B41","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1055\/s-0037-1613054","article-title":"Comparison of venography and ultrasound for the diagnosis of asymptomatic deep vein thrombosis in the upper body in children: results of the PARKAA study","volume":"87","author":"Male","year":"2002","journal-title":"Thromb Haemost."},{"key":"B42","doi-asserted-by":"publisher","first-page":"e737S","DOI":"10.1378\/chest.11-2308","article-title":"Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines","volume":"141","author":"Monagle","year":"2012","journal-title":"Chest."},{"key":"B43","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/j.1365-2141.2010.08225.x","article-title":"Aspects of anticoagulation in children","volume":"150","author":"Payne","year":"2010","journal-title":"Br J Haematol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"887S","DOI":"10.1378\/chest.08-0762","article-title":"Antithrombotic therapy in neonates and children: American college of chest physicians evidence-based clinical practice guidelines (8th Edition)","volume":"133","author":"Monagle","year":"2008","journal-title":"Chest."},{"key":"B45","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/S0022-3476(98)70343-9","article-title":"Guidelines for antithrombotic therapy in pediatric patients","volume":"132","author":"Andrew","year":"1998","journal-title":"J Pediatr."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1542\/peds.2009-0768","article-title":"Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007","volume":"124","author":"Raffini","year":"2009","journal-title":"Pediatrics."},{"key":"B47","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1001\/jama.2021.23182","article-title":"Effect of anticoagulant therapy for 6 weeks vs 3 months on recurrence and bleeding events in patients younger than 21 years of age with provoked venous thromboembolism: the kids-DOTT randomized clinical trial","volume":"327","author":"Goldenberg","year":"2022","journal-title":"JAMA."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.843643\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T09:32:19Z","timestamp":1674466339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.843643\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":47,"alternative-id":["10.3389\/fped.2022.843643"],"URL":"https:\/\/doi.org\/10.3389\/fped.2022.843643","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,23]]},"article-number":"843643"}}