Limitations
This study has several limitations. The study was subject to bias because of its retrospective nature. TTE has previously been reported to have a 75% sensitivity and 90% specificity for RAT detection, indicating that our reported incidence of 5.2% is likely to be lower than the true incidence of RAT development in patients with a CVC in the RA.12 Furthermore, detection of RAT was limited to patients receiving clinically indicated imaging. A study surveilling each patient with CVC tip in the RA would provide the most accurate estimate of catheter-associated RAT.