Abstract

Catheter-related right atrial thrombosis is an uncommon but potentially life-threatening complication of central venous catheter use, arising from mechanical endocardial irritation and endothelial injury. Although evidence from case reports is limited, its presentation appears to range from asymptomatic to severe events, such as pulmonary embolism and arrhythmias, with patients receiving hemodialysis at higher risk. The lack of evidence-based guidelines highlighted the need for a review to clarify clinical features, diagnostic methods, and optimal management strategies. Herein, a systematic review of case reports was conducted to identify cases of catheter-related right atrial thrombosis using multiple datasets. Only case reports, free full-text articles, and English-language-reviewed studies were included. Eight case reports of catheter-induced right atrial thrombosis were identified. All thrombi were located in the right atrium, with some extending into the superior vena cava or right ventricle, and three cases were associated with pulmonary embolism. Management methods included catheter removal, anticoagulation therapy, thrombolysis, and surgery. The predominant postoperative adverse events included atrial fibrillation, pneumothorax, and inflammatory responses. All patients showed clinical improvement, and the overall prognosis was favorable, with some requiring lifelong anticoagulation therapy. However, this review’s reliance on isolated case reports limited the applicability of these findings; therefore, further research is needed to define long-term outcomes and support patient-centered management of catheter-induced right atrial thrombosis.

Key words: Right atrial thrombosis, catheterization, systematic review, thrombosis management, case reports.