{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:25:06Z","timestamp":1760145906420,"version":"build-2065373602"},"reference-count":11,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Thrombosis is the abnormal formation of blood clots within blood vessels; it results from an imbalance between fibrinolytic, pro-coagulant, and anticoagulant systems. Pediatric arterial thrombosis, especially related to catheter usage, is an emerging issue with limited evidence. This study evaluates the efficacy of enoxaparin in treating arterial thrombosis in pediatric patients at a single center. Methods: A retrospective single-center study included children under 14 years old diagnosed with catheter-related arterial thrombosis (CAT) and treated with low-molecular-weight heparin (LMWH) at King Abdulaziz Medical City between 2016 and 2021. Patients without follow-up at our institution or those using other anticoagulants were excluded. Data collected included age, sex, weight, catheter type, location and degree of thrombosis, ultrasonographic results, treatment duration, hemoglobin and platelet levels, and missed refills. Radiologic confirmation of CAT was required for inclusion. Results: This study included 111 children treated with enoxaparin for non-cerebral arterial thrombosis. The median age at diagnosis was 3 months, with 58% being male patients. Most cases (87%) involved cardiac catheterization, and all were confirmed using ultrasonography. Complete thrombus resolution was achieved in 90% of patients, partial resolution in 8.1%, and 1.8% had no resolution. The median duration of enoxaparin therapy was 20 days. Multivariate analysis indicated that higher age and lower body weight were associated with a higher risk of non-resolution. Indwelling catheters also posed a greater risk of non-resolution compared to cardiac catheters. Conclusions: Enoxaparin proved effective in treating catheter-related arterial thrombosis in children, with high resolution rates and few side effects. This study helps inform treatment strategies in pediatric thrombosis management and highlights the need for further research to refine treatment durations and address patient risk factors.<\/jats:p>","DOI":"10.3390\/children11091139","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T11:51:46Z","timestamp":1726746706000},"page":"1139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Effectiveness of Enoxaparin in Treating Pediatric Arterial Thrombosis in Saudi Arabia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9423-6724","authenticated-orcid":false,"given":"Meshary","family":"Al-Meshary","sequence":"first","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nouf S.","family":"Alsagri","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asmaa","family":"AlZhrani","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husam I.","family":"Ardah","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-5437","authenticated-orcid":false,"given":"Mohammed A.","family":"Alnuhait","sequence":"additional","affiliation":[{"name":"Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 24381, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.thromres.2017.07.002","article-title":"Epidemiology, diagnosis, prevention and treatment of catheter-related thrombosis in children and adults","volume":"157","author":"Jaffray","year":"2017","journal-title":"Thromb. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/jth.15144","article-title":"Thrombosis in infants in the neonatal intensive care unit: Analysis of a large national database","volume":"19","author":"Robinson","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/j.1365-2141.2007.06973.x","article-title":"Common risk factors for both arterial and venous thrombosis","volume":"140","author":"Lowe","year":"2008","journal-title":"Br. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.thromres.2018.07.013","article-title":"Treatment of arterial thrombosis in children: Methods and mechanisms","volume":"169","author":"Rizzi","year":"2018","journal-title":"Thromb. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1055\/s-0038-1642635","article-title":"Catheter-Related Arterial Thrombosis in Neonates and Children: A Systematic Review","volume":"118","author":"Rizzi","year":"2018","journal-title":"Thromb. Haemost."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jpeds.2021.08.035","article-title":"Treatment of Catheter-Related Arterial Thrombosis in Children: A 15-Year Single- Center Experience","volume":"239","author":"Crameri","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jpeds.2020.12.061","article-title":"Patient Characteristics and Treatment Outcomes of Symptomatic Catheter-Related Arterial Thrombosis in Infants: A Retrospective Cohort Study","volume":"231","author":"Cohen","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1007\/s00134-007-0718-8","article-title":"Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease","volume":"33","author":"Bontadelli","year":"2007","journal-title":"Intensive Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e30756","DOI":"10.1002\/pbc.30756","article-title":"Pediatric arterial thrombosis: A single-institution cohort study of patient characteristics and thrombosis outcomes","volume":"71","author":"Abdelghani","year":"2024","journal-title":"Pediatr. Blood Cancer."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/ccd.25686","article-title":"Outcomes using a clinical practice pathway for the management of pulse loss following pediatric cardiac catheterization","volume":"85","author":"Glatz","year":"2015","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_11","doi-asserted-by":"crossref","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"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1139\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:59:53Z","timestamp":1760111993000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/9\/1139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,19]]},"references-count":11,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["children11091139"],"URL":"https:\/\/doi.org\/10.3390\/children11091139","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2024,9,19]]}}}