Urokinase therapy for Silastic catheter-induced intravascular thrombi in infants and children
A. Curnow, J. Idowu, E. Behrens, F. Toomey and K. Georgeson
Among the serious complications encountered with long-term, indwelling
Silastic central venous catheters are catheter-induced intravascular
thrombi. These thrombi are usually treated by removal of the catheter to
prevent thrombus propagation, embolization, or infection. We treated ten
patients with urokinase infusion who had experienced 12 incidents of
induced intravascular thrombi. Catheter phlebography and two-dimensional
echocardiography were used for diagnosis and follow-up. Eleven of the 12
episodes were treated successfully, with complete dissolution of the
thrombus. One patient with a calcific thrombus had only partial clot lysis
and required catheter removal. By utilizing urokinase infusion to treat
Silastic catheter-induced intravascular thrombi, nine of ten central venous
catheters were preserved and the possible need for thrombectomy was
averted. No serious complications were encountered. In our experience,
urokinase therapy has been an effective and safe method for treating
Silastic catheter-induced intravascular thrombi.
