Thrombolytic agents for arterial and venous thromboses in neonates

Abstract

No conclusions could be made as no eligible studies were found. It is time that a randomised controlled trial was performed comparing thrombolytic therapy to heparin therapy to aid neonatologists in the treatment of arterial and venous thromboses.

Successful Intraluminal Administration of Tissue Plasminogen Activator for Life-Threatening Obstructive Hematoma in Extremely Preterm Infants

“…tPA is the treatment of choice for thrombolysis and has been used to manage thrombosis in preterm infants. 5 6 7 8 Additionally, it is used to prevent catheter lumen occlusion and restore patency. 9…”

“…Because the obstruction was caused by massive GI bleeding, surgical removal of the hematoma required extensive intestinal resection, and the patient’s condition was unlikely to tolerate such surgery. Systemic thrombolytic therapy 5 8 was not considered a viable option because of its limited efficacy in resolving intraluminal hematomas and the high risk of complications, such as DIC and intraventricular hemorrhage (IVH). Therefore, direct intraluminal administration of tPA specifically targeting the hematoma was employed as an alternative therapeutic strategy.…”

Successful Intraluminal Administration of Tissue Plasminogen Activator for Life-Threatening Obstructive Hematoma in Extremely Preterm Infants

“…tPA is the treatment of choice for thrombolysis and has been used to manage thrombosis in preterm infants. 5 6 7 8 Additionally, it is used to prevent catheter lumen occlusion and restore patency. 9…”

“…Because the obstruction was caused by massive GI bleeding, surgical removal of the hematoma required extensive intestinal resection, and the patient’s condition was unlikely to tolerate such surgery. Systemic thrombolytic therapy 5 8 was not considered a viable option because of its limited efficacy in resolving intraluminal hematomas and the high risk of complications, such as DIC and intraventricular hemorrhage (IVH). Therefore, direct intraluminal administration of tPA specifically targeting the hematoma was employed as an alternative therapeutic strategy.…”

Near‐occlusive ductal thrombus extending to abdominal aorta in neonate: Recovery with thrombectomy

“…7 The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities. 8 Generally accepted strategies include anticoagulation with heparin (for non-occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy. While literature remains limited, surgical thrombectomy in neonates has been reported to be safe and effective at reducing occlusion and risk of end-organ, renal dysfunction and limb necrosis in previous case reports.…”

“…The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities 8 . Generally accepted strategies include anticoagulation with heparin (for non‐occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy.…”

Outcomes following neonatal portal vein thrombosis: A descriptive, single‐center study and review of anticoagulant therapy

“…The approach to the management of PVT in neonates is not standardized because of the absence of solid evidence with regard to the safety and efficacy of antithrombotic therapy and current reports of favorable outcomes based on conservative management. Therefore, a majority of healthcare providers err on the side of caution and assume a watch‐and‐wait approach because treatment needs to be judiciously weighed in terms of benefit versus risk of causing harm.…”

Successful Intraluminal Administration of Tissue Plasminogen Activator for Life-Threatening Obstructive Hematoma in Extremely Preterm Infants

“…tPA is the treatment of choice for thrombolysis and has been used to manage thrombosis in preterm infants. 5 6 7 8 Additionally, it is used to prevent catheter lumen occlusion and restore patency. 9…”

“…Because the obstruction was caused by massive GI bleeding, surgical removal of the hematoma required extensive intestinal resection, and the patient’s condition was unlikely to tolerate such surgery. Systemic thrombolytic therapy 5 8 was not considered a viable option because of its limited efficacy in resolving intraluminal hematomas and the high risk of complications, such as DIC and intraventricular hemorrhage (IVH). Therefore, direct intraluminal administration of tPA specifically targeting the hematoma was employed as an alternative therapeutic strategy.…”

Near‐occlusive ductal thrombus extending to abdominal aorta in neonate: Recovery with thrombectomy

“…7 The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities. 8 Generally accepted strategies include anticoagulation with heparin (for non-occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy. While literature remains limited, surgical thrombectomy in neonates has been reported to be safe and effective at reducing occlusion and risk of end-organ, renal dysfunction and limb necrosis in previous case reports.…”

“…The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities 8 . Generally accepted strategies include anticoagulation with heparin (for non‐occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy.…”

Outcomes following neonatal portal vein thrombosis: A descriptive, single‐center study and review of anticoagulant therapy

“…The approach to the management of PVT in neonates is not standardized because of the absence of solid evidence with regard to the safety and efficacy of antithrombotic therapy and current reports of favorable outcomes based on conservative management. Therefore, a majority of healthcare providers err on the side of caution and assume a watch‐and‐wait approach because treatment needs to be judiciously weighed in terms of benefit versus risk of causing harm.…”

Successful Intraluminal Administration of Tissue Plasminogen Activator for Life-Threatening Obstructive Hematoma in Extremely Preterm Infants

“…tPA is the treatment of choice for thrombolysis and has been used to manage thrombosis in preterm infants. 5 6 7 8 Additionally, it is used to prevent catheter lumen occlusion and restore patency. 9…”

“…Because the obstruction was caused by massive GI bleeding, surgical removal of the hematoma required extensive intestinal resection, and the patient’s condition was unlikely to tolerate such surgery. Systemic thrombolytic therapy 5 8 was not considered a viable option because of its limited efficacy in resolving intraluminal hematomas and the high risk of complications, such as DIC and intraventricular hemorrhage (IVH). Therefore, direct intraluminal administration of tPA specifically targeting the hematoma was employed as an alternative therapeutic strategy.…”

Near‐occlusive ductal thrombus extending to abdominal aorta in neonate: Recovery with thrombectomy

“…7 The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities. 8 Generally accepted strategies include anticoagulation with heparin (for non-occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy. While literature remains limited, surgical thrombectomy in neonates has been reported to be safe and effective at reducing occlusion and risk of end-organ, renal dysfunction and limb necrosis in previous case reports.…”

“…The management of acute, symptomatic thromboses in large arteries in neonates remains controversial, with no clear guidance from reputable authorities 8 . Generally accepted strategies include anticoagulation with heparin (for non‐occlusive, unthreatening thromboses), thrombolytic therapy and/or surgical thrombectomy.…”

Outcomes following neonatal portal vein thrombosis: A descriptive, single‐center study and review of anticoagulant therapy

“…The approach to the management of PVT in neonates is not standardized because of the absence of solid evidence with regard to the safety and efficacy of antithrombotic therapy and current reports of favorable outcomes based on conservative management. Therefore, a majority of healthcare providers err on the side of caution and assume a watch‐and‐wait approach because treatment needs to be judiciously weighed in terms of benefit versus risk of causing harm.…”