Successful treatment of a catheter-related right atrial thrombosis with recombinant tissue plasminogen activator and heparin

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Simone CesaroLuigi Zanesco

Abstract

Deep venous thrombosis is a possible complication of indwelling central venous catheters (CVC), with an incidence as high as 61%. We report a case of successful thrombolysis of a CVC-related right atrial thrombus in a pediatric cancer patient with recombinant human tissue plasminogen activator (0.1 mg/kg per h for 12 h) and heparin (10 IU/kg per h for 24 h) administered for 6 days. Daily echocardiographic examination showed progressive lysis of the thrombus. The thrombolytic treatment was associated with mild oozing from the venipuncture sites, but no major bleeding was noted; moreover, thrombin, thromboplastin time and fibrinogen were normal or only minimally altered. Anticoagulant therapy, with or without CVC removal, is the treatment of choice for uncomplicated CVC-related thrombosis. Fibrinolytic therapy may be indicated in some cases at risk of pulmonary embolism or to avoid open heart surgery. Recombinant human tissue plasminogen activator is increasingly used for thrombolytic treatment of organ and limb thrombosis, but experience with it in the pediatric hematology-oncology setting is still limited. This report showed that administering recombinant human tissue plasminogen activator in a pediatric cancer patient prior to...Continue Reading

Citations

Feb 5, 2008·Journal of Vascular Surgery·Hyun S KimMichael B Streiff
Sep 13, 2013·The Cochrane Database of Systematic Reviews·Reineke A SchootCornelia H van Ommen
Mar 23, 2010·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Janet Yk YangAnthony Kc Chan
Nov 15, 2013·Circulation·Therese M GigliaUNKNOWN American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council
May 16, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Frank R ErnstAlpesh N Amin
Sep 26, 2019·The Journal of Vascular Access·Minh-Ha TranPhu N Tran
Oct 6, 2006·Current Opinion in Anaesthesiology·Nikolaus A Haas, Silke A Haas

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