Central Venous Catheter (CVC) Associated Deep Vein Thrombosis (DVT) in Cancer Patients

Inclusion Criteria:

1. Male or female > 18 years of age.
2. Symptomatic acute upper limb thrombosis in the axillary, subclavian or internaljugular veins, with or without pulmonary embolism, associated with central venouscatheter objectively documented by compression ultrasonography, venogram orComputerized Tomography (CT) scan.
3. Diagnosis of active malignancy, as defined by patients who are either receiving activetreatment, or have metastatic disease or who have been diagnosed within the past twoyears.
4. Willing to provide written informed consent.

Exclusion Criteria:

1. Presence of dialysis catheters
2. Active bleeding or high risk for major bleeding
3. Platelet Count < 75 x 109/L
4. Creatinine Clearance < 30 mL/min
5. Currently on other anticoagulant with therapeutic intent for another indication
6. Pulmonary embolism accompanied by hemodynamic instability or oxygen requirement
7. Inability to infuse through the catheter after a trial of intraluminal thrombolytictherapy (2 mg tPA).
8. Patients with Acute Myeloid Leukemia (AML), Acute Lymphoblastic Leukemia (ALL) ormultiple myeloma with a bone marrow or stem cell transplant planned within the next 3months
9. Treatment for current episode > 7 days with any acceptable anticoagulant therapy
10. Concomitant use of p-glucoprotein and Cytochrome P450 3A4 (CYP3A4) inhibitors (forexample azole antifungals such as ketoconazole) or inducers (for example rifampicin,antiepileptics)
11. Recent coronary artery stent requiring dual anti-platelet therapy (for exampleacetylsalicylic acid [ASA] and Plavix)
12. If female of childbearing potential: pregnancy and/or breastfeeding