TY - JOUR
T1 - Obstructed central venous catheters
T2 - Restoring function with a 12‐hour infusion of low‐dose urokinase
AU - Haire, William D.
AU - Lieberman, Robert P.
AU - Lund, Gunnar B.
AU - Edney, James
AU - Wieczorek, Bridget M.
PY - 1990/12/1
Y1 - 1990/12/1
N2 - Thrombotic obstruction frequently prohibits infusion through or withdrawal of blood from central venous catheters and can occur in conjunction with symptomatic thrombosis of the subclavian vein. Thirty catheters were radiographically proved to be obstructed by thrombus and had not responded to at least one instillation of 5000 units of urokinase. All catheters were treated with a 12‐hour infusion of urokinase at the rate of 40,000 units/hour. the obstructing thrombus was either eliminated or reduced in size in all instances and full function was restored in all but one catheter. No bleeding complications were seen. Six patients with obstructed catheters also had symptoms of subclavian vein thrombosis. All patients with symptoms of subclavian vein obstruction became asymptomatic on anticoagulant therapy even though no attempt at dissolving the thrombus obstructing the subclavian vein was made. A 12‐hour infusion of low doses of urokinase can safely salvage function of obstructed catheters that otherwise may require replacement. Patients with concomitant subclavian vein thrombosis become asymptomatic on anticoagulant therapy without need to dissolve the obstructing thrombus.
AB - Thrombotic obstruction frequently prohibits infusion through or withdrawal of blood from central venous catheters and can occur in conjunction with symptomatic thrombosis of the subclavian vein. Thirty catheters were radiographically proved to be obstructed by thrombus and had not responded to at least one instillation of 5000 units of urokinase. All catheters were treated with a 12‐hour infusion of urokinase at the rate of 40,000 units/hour. the obstructing thrombus was either eliminated or reduced in size in all instances and full function was restored in all but one catheter. No bleeding complications were seen. Six patients with obstructed catheters also had symptoms of subclavian vein thrombosis. All patients with symptoms of subclavian vein obstruction became asymptomatic on anticoagulant therapy even though no attempt at dissolving the thrombus obstructing the subclavian vein was made. A 12‐hour infusion of low doses of urokinase can safely salvage function of obstructed catheters that otherwise may require replacement. Patients with concomitant subclavian vein thrombosis become asymptomatic on anticoagulant therapy without need to dissolve the obstructing thrombus.
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U2 - 10.1002/1097-0142(19901201)66:11<2279::AID-CNCR2820661105>3.0.CO;2-O
DO - 10.1002/1097-0142(19901201)66:11<2279::AID-CNCR2820661105>3.0.CO;2-O
M3 - Article
C2 - 2123125
AN - SCOPUS:0025690212
SN - 0008-543X
VL - 66
SP - 2279
EP - 2285
JO - Cancer
JF - Cancer
IS - 11
ER -