Successful thrombolysis by prolonged low-dose alteplase in catheter-directed infusion |
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Authors: | Ruud E Holmstrøm H Aagenaes I Hafsahl G Handeland M Kyte A Brosstad F |
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Institution: |
a Department of Paediatrics, The National Hospital, Oslo, Norway
b Department of Radiology, The National Hospital, Oslo, Norway
c Department of Paediatrics, Central Hospital of Vestfold, Oslo, Norway
d Research Institute for Internal Medicine, The National Hospital, Oslo, Norway |
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Abstract: | Catheter-directed thrombolysis is a sophisticated method in the treatment of thromboembolism with maximum effect on the thrombus and minimal systemic effect. The consequences are enhanced local thrombolysis and a reduction in general bleeding tendency, compared with systemic thrombolysis. At our institution, two children had successful thrombolysis by prolonged continuous catheter-directed low-dose alteplase. The first patient, a boy with Fontan physiology, was successfully treated for a massive pulmonary thromboembolism by catheter-directed very low-dose alteplase for five days. The second patient, who suffered from relapsing nephrotic syndrome, achieved satisfactory thrombolysis of an arterial leg thrombosis after four days of continuous catheter-directed low-dose alteplase.
Conclusion: Although catheter-directed thrombolysis seems to be a valuable method in thrombolytic therapy, there is a lack of evidence-based recommendations concerning dosage, effect of bolus, simultaneous anticoagulation and duration of treatment for children. |
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Keywords: | Alteplase arterial children thrombolysis thrombosis |
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