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Central Venous CatheterCAS-2NCT07014722

Contact Activation of Coagulation in Newly Inserted Central Venous Catheters

A study testing MERITMEDICAL Careflow™ Two-Lumen Central Venous Catheter, ARROW Two-Lumen Central Venous Catheter and ARROWg+ard Blue Plus® Two-Lumen Central Venous Catheter in people with Central Venous Catheter and Coagulation, run by Thomas Kander at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A central venous catheter (CVC) is a thin plastic tube placed into one of the body's large veins, typically in the neck or near the clavicle. CVCs are crucial for administering medications, fluids, and secure blood samples. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
MERITMEDICAL Careflow™ Two-Lumen Central Venous Catheter, ARROW Two-Lumen Central Venous Catheter and ARROWg+ard Blue Plus® Two-Lumen Central Venous Catheter
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
88 participants
Where
1 siteSweden
Study dates
10 Sep 2025to 15 Aug 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants must meet all of the following criteria to be included in the study:
  • Clinical indication for the placement of a two-lumen central venous catheter with length 150-160 mm.
  • Age ≥18 years.
  • Signed informed consent.

Who cannot join

  • Participants meeting any of the following criteria will be excluded:
  • Current use of anticoagulants or platelet inhibitors, except: Prophylactic low molecular weight heparin (LMWH), double prophylactic dose of LMWH, Acetylsalicylic acid (ASA).
  • Prothrombin complex (pK/INR) outside the normal range (0.9-1.2), platelet count <50 × 10⁹/L or haemoglobin < 80 g/L, if already available.
  • Known coagulopathic conditions, including but not limited to:
  • Activated protein C (APC) resistance,
  • Hemophilia A or B,
Show all 10Show fewer
  • Vitamin K deficiency,
  • Disseminated intravascular coagulation (DIC),
  • Antiphospholipid syndrome,
  • von Willebrand disease, Other known congenital or acquired bleeding disorders.

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Skåne University Hospital Lund

    Lund, Skåne County, 22242

Other trials in Sweden

About this study

Official title: Contact Activation of Coagulation in Newly Inserted Central Catheters - a Randomized Controlled Trial

A central venous catheter (CVC) is a thin plastic tube placed into one of the body's large veins, typically in the neck or near the clavicle. CVCs are crucial for administering medications, fluids, and secure blood samples. Although CVCs are an essential tool in healthcare, there are certain risks and complications associated with their use. CVCs can affect the body's coagulation system, potentially leading to the formation of blood clots at the site of the catheter. This can result in serious complications, and in some cases, increased morbidity and mortality. Despite the known risk of blood clot formation with catheter use, it is still do not fully understand why clots occur or how a newly inserted catheter affects the coagulation system.

The aim of this randomized controlled trial is to compare four different central venous catheters and their impact on the coagulation system.

Read more

Eighty eight patients ≥18 years of age, who require a CVC and agree to participate in the study will be randomly assigned to one of the four predetermined, commonly used, central venous catheters. Two blood samples will be taken from the newly inserted catheter. The first blood sample (Sample 1) will be collected within seconds after catheter insertion without pre-flushing the catheter with saline. The second blood sample (Sample 2) will be taken after the catheter has been flushed with at least 10 ml saline and the initial blood discarded. All samples will be taken from the distale lumen without any connectors. Samples 1 and 2 will then be analyzed to measure how the coagulation system is affected after contact with the inside surface of the CVC. The blood samples will also be compared between the different catheter types and in overall cohort irrespective of group .

The study could provide valuable information on how the coagulation system is affected after catheter insertion. This knowledge could help improve preventive measures to reduce the risk of blood clot formation and ensure safer blood sampling for patients with venous catheters.

Read the detailed description

This is a randomized controlled trial, designed to evaluate coagulation activation in response to four different commercially available central venous catheters (CVCs), all with similar internal surface areas. The study focuses on comparing changes in coagulation parameters, primarily clotting time (CT), measured using rotational thromboelastometry (ROTEM® NATEM), as well as additional ROTEM variables and standard coagulation markers.

Participants are included based on clinical need for central venous access, and are randomized using REDCap to receive one of four CVC types:

  1. MERITMEDICAL Careflow™ Two-Lumen Catheter (7 Fr, 150 mm, polyurethane, OD 2.4 mm)
  2. ARROW Two-Lumen Catheter (7 Fr, 160 mm, polyurethane, OD 2.5 mm)
  3. ARROWg+ard Blue Plus® Two-Lumen Catheter (8 Fr, 160 mm, polyurethane, OD 2.8 mm, chlorhexidine/silver sulfadiazine coating)
  4. Multicath 2 Expert UP Two-Lumen Catheter (7.5 Fr, 160 mm, polyurethane shaft embedded with silver ions, OD 2.5 mm)

Blood samples will be collected at two time points for each participant:

  • Sample 1: Immediately after catheter insertion, before flushing
  • Sample 2: After at least 10 ml saline flush and discard protocol

All catheters will be inserted without pre-procedural filling with saline.

Blood will be collected into Vacuette® CTAD tubes (Greiner Bio-One, Kremsmünster, Austria) containing sodium citrate, theophylline, adenosine, and dipyridamole, designed for hemostatic testing. The tubes will be inverted eight times immediately after blood collection and kept at 37°C until processing. ROTEM® analysis will be performed within 3 hours of blood collection. After the ROTEM® analysis, the remaining blood will undergo centrifugation at 4000g for 15 minutes, and 600-700 µL of plasma from each sample will be transferred into cryotubes, which will be immediately frozen and stored at -80°C for further analysis.

Laboratory and ROTEM® Analyses

ROTEM® analyses will be performed on whole blood using recalcified non-activated thromboelastometry (NATEM), in accordance with the manufacturer's instructions. Each test will be run for 60 minutes, measuring the following variables:

Clotting Time (CT) - time to initial fibrin formation Clot Formation Time (CFT) - speed of thrombus development Alpha Angle (α-angle) - kinetics of clot formation Maximum Clot Firmness (MCF) - measure of final clot strength

Routine Plasma-Based Coagulation Assays:

Prothrombin Time-International Normalized Ratio (PT-INR) Activated Partial Thromboplastin Time (aPTT)

The following coagulation markers will also be assessed:

Factor VII (FVII) and Factor XII (FXII) Thrombin-Antithrombin Complex (TAT)

Being tested
MERITMEDICAL Careflow™ Two-Lumen Central Venous Catheter, ARROW Two-Lumen Central Venous Catheter, ARROWg+ard Blue Plus® Two-Lumen Central Venous Catheter, Multicath 2 Expert UP Two-Lumen Central Venous Catheter
Keywords
coagulation, ROTEM, central venous catheter
Medical subject headings
Thrombosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MERITMEDICAL Careflow™ Two-Lumen Central Venous CatheterDevice

    7 Fr, 150 mm, radio-opaque polyurethane catheter (OD 2.4 mm)

  • ARROW Two-Lumen Central Venous CatheterDevice

    7 Fr, 160 mm, radio-opaque polyurethane catheter (OD 2.5 mm)

  • ARROWg+ard Blue Plus® Two-Lumen Central Venous CatheterDevice

    8 Fr, 160 mm, radio-opaque polyurethane catheter with antimicrobial coating

  • Multicath 2 Expert UP Two-Lumen Central Venous CatheterDevice

    7.5 Fr, 160 mm, central venous catheter (OD 2.5 mm). Polyurethane shaft embedded with silver ions.

Study groups in NCT07014722
Study groupRoleWhat they receive
Group A: MERITMEDICAL Careflow™Active comparatorParticipants will receive a MERITMEDICAL Careflow™ two-lumen 7 Fr, 150 mm, polyurethane central venous catheter (OD 2.4 mm).
Receives: Device: MERITMEDICAL Careflow™ Two-Lumen Central Venous Catheter
Group B: ARROWActive comparatorParticipants will receive an ARROW two-lumen 7 Fr, 160 mm, polyurethane central venous catheter (OD 2.5 mm).
Receives: Device: ARROW Two-Lumen Central Venous Catheter
Group C: ARROWg+ard Blue Plus®Active comparatorParticipants will receive an ARROWg+ard Blue Plus® two-lumen 8 Fr, 160 mm, polyurethane catheter (OD 2.8 mm) with chlorhexidine and silver sulfadiazine coating.
Receives: Device: ARROWg+ard Blue Plus® Two-Lumen Central Venous Catheter
Group D: Multicath 2 Expert UPActive comparatorParticipants will receive a Multicath 2 Expert UP two-lumen 7.5 Fr, 160 mm, polyurethane shaft embedded with silver ions (OD 2.5 mm).
Receives: Device: Multicath 2 Expert UP Two-Lumen Central Venous Catheter

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in ROTEM NATEM Clotting Time (CT) (seconds) between Sample 1 and Sample 2

    The primary endpoint is the difference in clotting time (CT), measured using ROTEM NATEM, between two blood samples collected from each participant. Sample 1 is collected immediately after catheter insertion, and Sample 2 is collected after a standardized flush and discard procedure. The change in CT will be compared across the four catheter groups to evaluate differences in coagulation activation.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

Secondary outcomes (9)
  1. Change in ROTEM NATEM CT between Sample 1 and Sample 2: within-group and overall cohort comparisons.

    Change in ROTEM NATEM CT between Sample 1 and Sample 2: within-group and overall cohort comparisons.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  2. Change in ROTEM NATEM Clot Formation Time (CFT) (seconds) between Sample 1 and Sample 2

    Between-group comparison of the change in ROTEM NATEM Clot Formation Time (ΔCFT) (seconds) between Sample 1 and Sample 2, with within-group comparisons of CFT and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  3. Change in ROTEM Alpha Angle (α-angle) (degrees) between Sample 1 and Sample 2

    Between-group comparison of the change in ROTEM NATEM Alpha Angle (Δα-angle, degrees) between Sample 1 and Sample 2, with within-group comparisons of α-angle and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  4. Change in ROTEM Maximum Clot Firmness (MCF) (mm) between Sample 1 and Sample 2

    Between-group comparison of the change in ROTEM NATEM Maximum Clot Firmness (MCF) (mm) between Sample 1 and Sample 2, with within-group comparisons of MCF and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  5. Change in Prothrombin Time - International Normalized Ratio (PT-INR) (continous unitless variable) between Sample 1 and Sample 2

    Between-group comparison of the change in Prothrombin Time - International Normalized Ratio (PT-INR) between Sample 1 and Sample 2, with within-group comparisons of PT-INR and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  6. Change in Activated Partial Thromboplastin Time (aPTT) (seconds) between Sample 1 and Sample 2

    Between-group comparison of the change in Activated Partial Thromboplastin Time (aPTT) (seconds) between Sample 1 and Sample 2, with within-group comparisons of aPTT and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  7. Change in Factor VII Activity (FVII) (kIU/L) between Sample 1 and Sample 2

    Between-group comparison of the change in Factor VII Activity (FVII) (kIU/L) between Sample 1 and Sample 2, with within-group comparisons of FVII and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  8. Change in Factor XII Activity (FXII) (kIU/L) between Sample 1 and Sample 2

    Between-group comparison of the change in Factor XII Activity (FXII) (kIU/L) between Sample 1 and Sample 2, with within-group comparisons of FXII and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Time Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

  9. Change in Thrombin-Antithrombin Complex Concentration (TAT) (mikrogr/L) between Sample 1 and Sample 2

    Between-group comparison of the change in Thrombin-Antithrombin Complex Concentration (TAT) (mikrogr/L) between Sample 1 and Sample 2, with within-group comparisons of TAT and an overall cohort comparison of Sample 1 versus Sample 2.

    Measured: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2025
  2. Study start10 Sep 2025
  3. Primary completion15 May 2026
  4. Study completion15 Aug 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
88 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07014722
Sponsor's protocol ID
CAS-2
Acronym
CAS-2
Status last verified
Sep 2026
First submitted
12 May 2025
Last updated
16 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data (IPD) underlying the study results will be made available upon reasonable request. Data will be completely anonymized prior to sharing, in accordance with applicable data protection regulations. Requests from both academic researchers and commercial entities (e.g., device manufacturers) will be considered. All requests will undergo review to assess scientific validity and compliance with ethical standards.

Publications

  • Zorlak A, Naddi L, Borgquist O, Kander T. Contact activation of coagulation in newly inserted central venous catheters (CAS-2): protocol for a randomised controlled study comparing four commercially available catheters. BMJ Open. 2026 Jun 28;16(6):e119213. doi: 10.1136/bmjopen-2026-119213.

    PubMed 42366009

Questions about this trial

What is this clinical trial studying?

A study testing MERITMEDICAL Careflow™ Two-Lumen Central Venous Catheter, ARROW Two-Lumen Central Venous Catheter and ARROWg+ard Blue Plus® Two-Lumen Central Venous Catheter in people with Central Venous Catheter and Coagulation, run by Thomas Kander at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in ROTEM NATEM Clotting Time (CT) (seconds) between Sample 1 and Sample 2 (time frame: Immediately after catheter insertion (Sample 1) and after flush and discard, within one hour (Sample 2)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07014722, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2026.

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