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Thrombolytic Therapy Using Urokinase for Management of Central Venous Catheter Thrombosis

Jung Tack Son1, Sun Young Min1, Jae Il Kim1

  • 1Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Vascular Specialist International
|July 29, 2015
PubMed

Insights

Bedside thrombolysis with urokinase effectively managed central venous catheter (CVC) thrombosis in 75% of patients. This urokinase protocol rarely required reintervention for CVC thrombosis, offering a successful treatment option.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Critical Care Medicine

Background:

  • Management of central venous catheter (CVC) thrombosis protocols vary.
  • Efficacy of CVC thrombosis management methods is infrequently reported.
  • Investigating effective CVC thrombosis treatments is crucial for patient care.

Purpose of the Study:

  • To evaluate the effectiveness of bedside thrombolysis using urokinase for managing CVC thrombosis.
  • To determine the success rate of urokinase in recanalizing thrombosed CVCs.
  • To assess the need for reintervention after urokinase therapy for CVC thrombosis.

Main Methods:

  • Retrospective review of CVC insertions between April 2012 and June 2014.
  • Implemented a standardized protocol for CVC management.
  • Administered 5,000 U of urokinase directly into thrombosed CVCs.

Main Results:

  • Thrombosis occurred in 8.8% of 137 CVCs; infection in 5.8%.
  • Urokinase successfully recanalized CVCs in 75% of patients (9/12).
  • Peripherally inserted central catheter (PICC) group showed higher recanalization rates (87.5%) than chemoport group (50%).
  • Only 2.2% of patients required reintervention for CVC thrombosis with urokinase therapy.
  • Independent risk factors for CVC thrombosis included age <60, PICC use, and catheter tip location above the superior vena cava.

Conclusions:

  • Bedside thrombolysis with urokinase is an effective treatment for CVC thrombosis.
  • Applying a urokinase protocol for CVC thrombosis management significantly reduces the need for reintervention.
Abstract

Keywords:
Central venous cathetersThrombosisUrokinase-type plasminogen activator

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