Consensus on prevention and management of thrombosis related to temporary nontunneled central venous catheters in hemodialysis

Vollständiger Abstract

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Nontunneled central venous catheters (CVCs) are widely used for urgent and short-term vascular access in blood purification therapy, but catheter-related thrombosis remains a frequent and clinically important complication. It may cause catheter dysfunction, treatment interruption, premature catheter removal, additional interventions, pulmonary embolism, and increased mortality risk. This consensus summarizes current evidence on the epidemiology, classification, risk factors, prevention, evaluation, and management of thrombosis associated with nontunneled CVCs in blood purification therapy. Key preventive strategies include appropriate catheter indications, minimized dwell time, preference for the right internal jugular vein, ultrasound-guided insertion, standardized catheter care, and appropriate locking solutions. Evaluation should combine clinical recognition with stepwise imaging, with color Doppler ultrasonography as the first-line modality. Management should be individualized according to thrombus location and severity, including thrombolysis, anticoagulation, catheter removal, and selective interventional or surgical treatment.