Reteplase: nursing implications for catheter-directed thrombolytic therapy for peripheral vascular occlusions

Several studies since 1998 have shown the efficacy of catheter-directed thrombolytic therapy with reteplase. Reteplase is a plasminogen activator that penetrates the thrombus and causes lysis. This catheter-directed approach has been used to treat both arterial and venous occlusions, with a success rate of 72% to 88%. The most serious complication associated with thrombolytic therapy is intracranial hemorrhage. Patients should be admitted to the intensive care unit for monitoring of neurological status, vital signs, laboratory values (hematocrit, hemoglobin level, activated partial thromboplastin time, and fibrinogen concentration), and bleeding or oozing at puncture sites. Staff nurses in the intensive care unit must be aware of this important thrombolytic therapy, its indications, and its implications for nursing interventions.