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Published on: September 9, 2011
Weekly prophylactic urokinase instillation in tunneled central venous access devices
C E Ray1, S S Shenoy, P L McCarthy
1Department of Interventional Radiology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Purpose:
To determine the safety and efficacy of weekly prophylactic urokinase therapy in tunneled central venous access devices (VADs).
Materials And Methods:
A prospective, randomized study was performed in 105 patients who underwent tunneled VAD placement between March 1997 and April 1998. The patients were randomized to receive either twice-daily heparin flushes (14 heparin flushes per week; group A, n = 52) or twice-daily heparin flushes with once-weekly urokinase (UK) instillation (13 heparin flushes, one UK flush per week; group B, n = 53). Patients were followed up by examination and/or interview at 1, 3, and 6 months for signs and symptoms of delayed catheter-related complications.
Results:
The total number of indwelling catheter-days was similar between groups (5,450 in group A, 5,276 in group B). The total number of infectious complications and fibrin sheaths formed was greater for group A (n = 11; 21.1%) than group B (n = 3; 5.7%) (P = .02). There were no side effects noted from the prophylactic UK administrations.
Conclusion:
Prophylactic UK is advantageous in preventing delayed catheter-related complications.
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