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Venous port salvage utilizing low dose tPA
Cliff J Whigham1, Jason I Lindsey, Chad J Goodman
1Baylor College of Medicine, Department of Radiology, One Baylor Plaza-MS 360, Houston, Texas 77030-3487, USA. cliffw@bcm.tmc.edu
Cardiovascular and Interventional Radiology
|October 23, 2002
Summary
Low-dose tissue plasminogen activator (tPA) effectively salvages malfunctioning venous access ports caused by fibrin sheaths. This safe and efficient treatment restores catheter function in over 90% of cases, avoiding complications.
Area of Science:
- Vascular Access Devices
- Interventional Radiology
- Pharmacology
Background:
- Catheter occlusion due to fibrin sheath formation is a frequent complication in patients with long-term venous access ports.
- This malfunction necessitates interventions to restore device patency and avoid removal.
Purpose of the Study:
- To evaluate the efficacy and safety of low-dose tissue plasminogen activator (tPA) for salvaging venous access ports with catheter malfunction secondary to fibrin sheath formation.
Main Methods:
- A prospective study involving 50 patients with 56 instances of venous port dysfunction due to fibrin sheaths.
- Low-dose tPA was instilled into the malfunctioning ports.
- Successful restoration of function was confirmed by venography.
Main Results:
- The study included 45 patients receiving chemotherapy and 5 for antibiotics.
- The average dose of tPA used was 2.29 mg.
- A high success rate of 92.9% (52 out of 56 occlusive events) was achieved in salvaging catheter function.
- No bleeding complications were reported.
Conclusions:
- Low-dose tPA is a safe and effective therapeutic option for managing venous port malfunction caused by fibrin sheaths.
- This approach can successfully salvage the function of long-term venous access ports, improving patient care.