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Effective use of alteplase for occluded tunneled venous catheter in hemodialysis patients.
Mendes, Marcela L; Castro, João H; Silva, Tricya N; Barretti, Pasqual; Ponce, Daniela.
Afiliação
  • Mendes ML; Internal Medicine, University of São Paulo State-Botucatu School of Medicine-UNESP, Botucatu, São Paulo, Brazil.
Artif Organs ; 38(5): 399-403, 2014 May.
Article em En | MEDLINE | ID: mdl-24117542
Despite their propensity for significant infectious and mechanical complications, tunneled central venous catheters (CVCs) have become a common means of vascular access in the world for patients requiring chronic hemodialysis for end-stage renal disease. The objective of this study was to explore if cryopreserved solutions of the thrombolytic agent alteplase could be used as an effective, safe, and economically reasonable alternative in hemodialysis patients with occluded tunneled CVC. Patients requiring chronic hemodialysis and presenting with occluded tunneled CVC received a sufficient volume of the alteplase solution to fill the occluded catheter. To make alteplase economically feasible, it was diluted to 1-mg/mL aliquots and they were stored at -20°C until use. Eighty-one patients accounting for 179 attempted clearances were assessable for efficacy. One hundred forty-seven (82.1%) of the 179 catheter clearance attempts resulted in successful catheter clearance after one dose. Twenty-seven (15.1%) of all occluded CVCs were successful after two doses whereas five (2.8%) were not. No adverse events were reported. Cryopreserved 1-mg/mL aliquots of alteplase are safe and effective in the clearance of occluded CVC for hemodialysis patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Grau de Desobstrução Vascular / Diálise Renal / Ativador de Plasminogênio Tecidual / Fibrinolíticos / Cateteres Venosos Centrais Tipo de estudo: Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Artif Organs Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Trombose / Grau de Desobstrução Vascular / Diálise Renal / Ativador de Plasminogênio Tecidual / Fibrinolíticos / Cateteres Venosos Centrais Tipo de estudo: Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Artif Organs Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos