ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Critical Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1631247
Impact of Catheter-to-Vein Diameter Ratio on Thrombosis in Pediatric Central Venous Catheterization
Provisionally accepted
Fevzi Kahveci1*
Nur Ayça Çelik2
Hacer Uçmak1
Anar Gurbanov1Mert Kaan Coşkun2Hasan Özen1Şükriye Yılmaz3
Merve Havan1Suat Fitöz3Mehmet Ertem4
Tanıl Kendirli1- 1Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye
- 2Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye
- 3Department of Radiology, Ankara University Faculty of Medicine, Ankara, Türkiye
- 4Division of Pediatric Hematology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye
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Objective: Catheter-related thrombosis is a common complication of central venous catheter insertion. As the use of central venous catheters increases in pediatric critical care settings, catheter-related thrombosis is becoming more common among patients who typically have multiple risk factors for thromboembolism. We aimed to investigate impact of catheter-to-vein diameter ratio on thrombosis in pediatric central venous catheterization. Methods: Single-center, prospective study. In our study, thrombosis risk factors and patient-related factors were excluded. Results: A total of 50 patients were included in our study. Thrombosis was observed in 34% of the patients. When comparing thrombotic and nonthrombotic patients, factors such as a low aPTT value, dialysis catheter use, certain mutations that may cause thrombosis, a high catheter-to-blood vessel diameter ratio (C/VR), and a high catheter area-to-blood vessel area ratio (C/VA) are associated with an increased risk of thrombosis. In backwards logistic regression analysis of thrombosis risk, older age, a decreased catheter area, a high C/VA ratio, and the use of dialysis catheters contributed to an increased risk of thrombosis. Patients with dialysis catheters have a 64.9 times greater risk of thrombosis than do those with central venous catheters. The C/VR, with a cut-off value of 0.197, and the C/VA, with a cut-off value of 0.088, are effective indicators in ROC analysis for thrombosis. Conclusion: In conclusion, selecting a catheter with a diameter-to-vessel diameter ratio of less than 1:5 in normovolaemic paediatric patients should be considered as a strategy to reduce the risk of catheter-related thrombosis.
Keywords: Thrombosis, catheter vessel diameter ratio, Central venous catheter (CVC), Pediatrics, PICU (pediatric intensive care unit)
Received: 19 May 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Kahveci, Çelik, Uçmak, Gurbanov, Coşkun, Özen, Yılmaz, Havan, Fitöz, Ertem and Kendirli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fevzi Kahveci, Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye
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