Early catheter-related thrombosis in oncology patients with central venous access devices: a narrative review of incidence, mechanisms and clinical implications.

Central venous access devices (CVADs) are widely used in oncology patients to facilitate administration of chemotherapy and supportive treatments. However, catheter-related thrombosis (CRT) remains one of the most important complications associated with their use. Although overall CRT incidence has been extensively studied, early CRT occurring shortly after catheter implantation remains insufficiently characterized. A narrative review of the literature was performed focusing on studies evaluating CRT in oncology patients with central venous access devices. Relevant studies were identified through searches of the PubMed database and reference lists of selected articles. A total of thirteen studies published between 2005 and 2025 were included in this review. The studies consisted of randomized controlled trials, observational studies, non-randomized studies and retrospective cohort studies, with sample sizes ranging from 48 to 1331 participants. Most studies focused on peripherally inserted central catheters (PICCs), while fewer evaluated centrally inserted central catheters (CICC) or implantable ports. Reported CRT incidence varied widely depending on catheter type, ranging from 3.3% to 61.3% for PICCs, 6.5% to 49% for CICCs and 1% to 7.1% for implantable ports. Early CRT (defined as ≤ 7 days after catheter implantation) was rarely evaluated and was reported in only three studies, with incidence ranging from 2.4% to 48.39%. Across studies assessing thromboprophylaxis, overall CRT incidence ranged from 3.1% to 16.1% in control groups and from 0.4% to 14.1% in intervention groups. CRT remains a clinically relevant complication in oncology patients requiring central venous access. Available evidence suggests substantial variability in thrombosis incidence across catheter types, with generally higher rates observed in PICCs compared with implantable ports. Data on early CRT remain limited and heterogeneous, underscoring the need for prospective studies specifically addressing early thrombotic events following catheter implantation. Improved risk stratification and standardized approaches to prevention and management may enhance clinical outcomes.