Efficacy and safety evaluation of thromboprophylaxis strategies for central venous catheter-related thrombosis in cancer patients: a bayesian network meta-analysis and bibliometric analysis

Background: Catheter-related thrombosis (CRT) is a common complication following central venous catheter (CVC) placement in patients with cancer, increasing mortality and adverse outcomes. However, robust evidence on optimal prophylactic anticoagulation strategies remains limited. Methods: A bibliometric analysis was performed on English-language publications on CVC-associated thrombosis prevention in cancer patients indexed in the Web of Science (2000-2025). Descriptive analyses were conducted using the Bibliometrix package in R, with visualizations generated by VOSviewer and CiteSpace. For the network meta-analysis, clinical studies on prophylactic anticoagulation for CRT in cancer patients were systematically searched (up to 28 May 2025), and a Bayesian network meta-analysis was performed using R packages netmeta and gemtc. Results: A total of 680 publications from 52 countries were identified. The United States led in both publication output and citations, and research focus shifted from warfarin and low-molecular-weight heparin (LMWH) toward direct oral anticoagulants (DOACs). Nineteen clinical studies were included in the network meta-analysis. Compared with no prophylaxis, apixaban reduced CRT incidence (OR 0.31, 95% CI 0.17-0.54), and vitamin K antagonists (VKA), rivaroxaban, and LMWH also showed significant reductions. VKA was associated with a higher bleeding risk than apixaban (OR 2.29, 95% CI 1.08-4.98) and no prophylaxis. No significant differences were found for major bleeding, all-cause mortality, or adverse events among other treatments. Conclusion: Apixaban, VKA, rivaroxaban, and LMWH effectively prevent CRT, while VKA is associated with an increased bleeding risk. These findings support the favorable effect of DOACs on CRT prevention. Long-term safety data from large-scale, multicenter trials are still needed. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251218825.