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Successful thrombolysis by prolonged low-dose alteplase in catheter-directed infusion

E Ruud1, H Holmstrøm, I Aagenaes

  • 1Departments of Paediatrics, The National Hospital, Oslo, Norway. ellen.ruud@rikshospitalet.no

Acta Paediatrica (Oslo, Norway : 1992)
|September 2, 2003
PubMed

Insights

Catheter-directed thrombolysis effectively treated thromboembolism in two children using low-dose alteplase. This method enhanced local clot breakdown with minimal systemic effects, showing promise for pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Interventional Radiology
  • Hematology

Background:

  • Thromboembolism poses significant risks in pediatric patients.
  • Systemic thrombolysis can lead to adverse effects.
  • Catheter-directed thrombolysis offers a localized treatment approach.

Observation:

  • Two pediatric cases of thromboembolism were treated with catheter-directed thrombolysis.
  • A boy with Fontan physiology received treatment for pulmonary thromboembolism.
  • A patient with nephrotic syndrome was treated for arterial leg thrombosis.

Findings:

  • Successful thrombolysis was achieved in both pediatric patients.
  • Prolonged, continuous, low-dose alteplase via catheter was administered.
  • The treatment resulted in enhanced local thrombolysis and reduced systemic bleeding.
  • Very low-dose alteplase was used for five days in the first case.
  • Low-dose alteplase was used for four days in the second case.

Implications:

  • Catheter-directed thrombolysis is a viable option for pediatric thromboembolism.
  • Further research is needed to establish evidence-based guidelines for pediatric use.
  • Specific recommendations for dosage, duration, and anticoagulation are lacking.
Abstract

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