Effective Use of Alteplase for Occluded Tunneled Venous Catheter in Hemodialysis Patients


Autoria(s): Mendes, Marcela L.; Castro, Joao H.; Silva, Tricya N.; Barretti, Pasqual; Ponce, Daniela
Contribuinte(s)

Universidade Estadual Paulista (UNESP)

Data(s)

03/12/2014

03/12/2014

01/05/2014

Resumo

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 degrees 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.

Formato

399-403

Identificador

http://dx.doi.org/10.1111/aor.12186

Artificial Organs. Hoboken: Wiley-blackwell, v. 38, n. 5, p. 399-403, 2014.

0160-564X

http://hdl.handle.net/11449/111167

10.1111/aor.12186

WOS:000334969000008

Idioma(s)

eng

Publicador

Wiley-Blackwell

Relação

Artificial Organs

Direitos

closedAccess

Palavras-Chave #Hemodialysis #Tunneled central venous catheter #Thrombosis #Alteplase
Tipo

info:eu-repo/semantics/article