PMID: 11919252Mar 29, 2002Paper

Safe and cost effective use of alteplase for the clearance of occluded central venous access devices

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
J P TimoneyL B Saltz

Abstract

To determine whether cryopreserved solutions of the thrombolytic agent alteplase could be used as a safe, effective, and economically reasonable alternative to urokinase in patients presenting with occluded central venous access devices (CVADs). Alteplase has been reported as an efficacious alternative to urokinase for treatment of occluded CVADs. However, the practicality of using alteplase as the thrombolytic of choice for this indication remained conjectural. To make this approach economically feasible, alteplase was diluted to 1 mg/mL and 2.5-mL aliquots were stored at -20 degrees C until use. A need to confirm that the cryopreserving and thawing of the reconstituted solution did not compromise the safety and efficacy reported from prior trials was recognized. A quality assessment initiative was undertaken to concurrently monitor the safety and efficacy of this approach. Patients presenting with occluded CVADs received a sufficient volume of the thawed alteplase solution to fill the occluded catheter(s). Data, including efficacy, adverse reactions, dwell time, and catheter type, were collected over a 5-month period. One hundred twenty-one patients accounting for 168 attempted clearances were assessable for safety and effica...Continue Reading

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Citations

Jan 7, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Eva Van BraeckelLisa McNally
Jan 8, 2004·Journal of Vascular and Interventional Radiology : JVIR·Chin Y LiuLance K Heilbrun
Aug 31, 2007·Pediatric Blood & Cancer·Roderick SkinnerUNKNOWN Paediatric Oncology Nursing Forum (PONF) Supportive Care Group
Oct 15, 2013·Artificial Organs·Marcela L MendesDaniela Ponce
Oct 30, 2004·Hematology/oncology Clinics of North America·Janna M Journeycake, Marilyn J Manco-Johnson
Jun 10, 2003·Clinical Journal of Oncology Nursing·Lora Wingerter
Nov 25, 2005·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Elizabeth A Krzywda, Deborah A Andris
Oct 6, 2006·Current Opinion in Anaesthesiology·Nikolaus A Haas, Silke A Haas
Jul 2, 2014·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·Margaret G Lyons, Ann G Phalen
Oct 6, 2005·Applied and Environmental Microbiology·Ewa KuczynskaYakov Pachepsky
Mar 23, 2006·The Journal of Vascular Access·J HaymondJ Jastrzebski

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