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Tenecteplase for malignant pericardial effusion.

Kelly K Johnson1, Dwarakraj Soundarraj, Parag Patel

  • 1Department of Pharmacy, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA. kelly.johnson@advocatehealth.com

Pharmacotherapy
|January 27, 2007
PubMed
Summary
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Tenecteplase effectively facilitated pericardial drainage in a patient with malignant pericardial effusion. This approach may prevent the need for repeated catheter replacement when drainage slows.

Area of Science:

  • Cardiology
  • Thoracic Surgery

Background:

  • Pericardial effusions often require catheter drainage for fluid removal.
  • Fibrinous or loculated effusions can impede drainage, leading to reaccumulation.
  • Limited guidance exists for selecting fibrinolytic agents and dosages for pericardial drainage.

Observation:

  • A case study involving a 79-year-old woman with malignant pericardial effusion is presented.
  • The patient underwent intrapericardial administration of tenecteplase to improve catheter drainage.
  • Three doses of tenecteplase (15 mg, 7.5 mg, 7.5 mg) were administered over three days.

Findings:

  • Intrapericardial tenecteplase resulted in significant drainage of the pericardial effusion.
  • The patient experienced a transient episode of hemodynamically stable atrial fibrillation as the only adverse effect.

Related Experiment Videos

  • No other adverse events were noted during the treatment period.

    • Implications:

    • Fibrinolytic agents, such as tenecteplase, can be a valuable tool for managing challenging pericardial effusions.
    • This therapeutic strategy may reduce the frequency of catheter replacement procedures.
    • Further research into fibrinolytic use for pericardial drainage is warranted to establish optimal protocols.