Low-dose streptokinase for occluded Hickman catheters

Zajko, AB; Reilly, JJ; Km, Bron; Desai, Rahul R. Prabhu; Dl, Steed

doi:10.2214/ajr.141.6.1311

Cited by 21 publications

(3 citation statements)

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“…Fibrin sleeve formation is usually asymptomatic, although it may occasionally cause occlusion of the catheter tip. 30 Although all or part of the sleeve may peel away from the catheter during removal, 3 this does not seem to cause clinically apparent pulmonary embolism. Mural/occlusive thrombi most often cause ipsilateral shoulder pain and arm swelling.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Catheter‐Related Thrombosis

Williams

1990

Clinical Cardiology

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The use of indwelling central catheters for administration of chemotherapy, blood products, and parenteral nutrition is becoming increasingly common. Thrombosis, manifested as formation of either a fibrin sleeve around the catheter or a thrombus adherent to the vessel wall, is a major complication of the use of such catheters. Although frequently asymptomatic, thrombosis may cause catheter occlusion, vascular obstruction, septic phlebitis, or pulmonary embolism. The pathophysiology and management of catheter thrombosis are discussed.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Catheter‐Related Thrombosis

Williams

1990

Clinical Cardiology

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“…7,13,14,[32][33][34] A trial comparing mechanical manipulation versus catheter exchange showed that tunneled hemodialysis catheters with over-the-wire exchange is superior to percutaneous fibrin sheath stripping in short-and long-term (4 months) patency rates. 18 Gray et al compared mechanical manipulation versus thrombolysis and demonstrated that urokinase in central dialysis catheters is equal to fibrin sheath stripping in the short term (45 days).…”

Section: Discussionmentioning

confidence: 99%

“…Depending on the type of injection, a limited local or systemic effect results. [7][8][9][10][11][12][13][14] Apart from pharmacologic treatment, invasive angiographic stripping of the fibrin sheath surrounding the port-catheter or surgical exchange of the malfunctioning port-catheter are described. 10,[15][16][17][18][19] The aim of the study was to evaluate a minimally invasive and simple approach for adequate management of port-catheter thrombosis.…”

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confidence: 99%

Local Low-Dose Thrombolysis for Safe and Effective Treatment of Venous Port-Catheter Thrombosis

et al. 2014

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Obstructed central venous catheters: Restoring function with a 12-hour infusion of low-dose urokinase

Haire

Lieberman

Lund

et al. 1990

Cancer

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Thrombotic obstruction frequently prohibits infusion through or withdrawal of blood from central venous catheters and can occur in conjunction with symptomatic thrombosis of the subclavian vein. Thirty catheters were radiographically proved to be obstructed by thrombus and had not responded to at least one instillation of 5000 units of urokinase. All catheters were treated with a 12-hour infusion of urokinase at the rate of 40,000 units/hour. The obstructing thrombus was either eliminated or reduced in size in all instances and full function was restored in all but one catheter. No bleeding complications were seen. Six patients with obstructed catheters also had symptoms of subclavian vein thrombosis. All patients with symptoms of subclavian vein obstruction became asymptomatic on anticoagulant therapy even though no attempt at dissolving the thrombus obstructing the subclavian vein was made. A 12-hour infusion of low doses of urokinase can safely salvage function of obstructed catheters that otherwise may require replacement. Patients with concomitant subclavian vein thrombosis become asymptomatic on anticoagulant therapy without need to dissolve the obstructing thrombus.

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Low-dose streptokinase for occluded Hickman catheters

Cited by 21 publications

References 0 publications

Catheter‐Related Thrombosis

Catheter‐Related Thrombosis

Local Low-Dose Thrombolysis for Safe and Effective Treatment of Venous Port-Catheter Thrombosis

Obstructed central venous catheters: Restoring function with a 12-hour infusion of low-dose urokinase

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