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Pediatric Thrombolysis: A Practical Approach

Cristina Tarango1, Marilyn J Manco-Johnson2

  • 1Division of Hematology, Department of Pediatrics, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center Cincinnati, University of Cincinnati, Cincinnati, OH, United States.

Frontiers in Pediatrics
|December 23, 2017
PubMed

Insights

Pediatric venous thromboembolic disease is rising. Thrombolysis and thrombectomy offer rapid symptom relief for severe cases but carry bleeding risks and require specialized expertise.

Area of Science:

  • Pediatric Hematology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Pediatric venous thromboembolic disease (VTE) incidence is increasing in hospitalized children.
  • Anticoagulation is the primary treatment, but advanced interventions are gaining traction.

Purpose of the Study:

  • To review current thrombolysis and thrombectomy techniques for pediatric thrombosis.
  • To summarize the benefits and challenges associated with these interventions.

Main Methods:

  • Review of current literature on systemic thrombolysis, endovascular thrombolysis, and mechanical thrombectomy in pediatric patients.
  • Analysis of indications, efficacy, and complication rates.

Main Results:

  • Thrombolysis is vital for life- or limb-threatening thrombosis, improving venous patency and symptoms.
  • Increased minor bleeding observed with thrombolysis compared to anticoagulation; major bleeding remains a concern.
  • Endovascular procedures require specialized expertise, which may not be universally available.

Conclusions:

  • Thrombolysis and thrombectomy are valuable tools for severe pediatric thrombosis.
  • Careful consideration of bleeding risks and procedural expertise is necessary for optimal patient outcomes.

Keywords:
DVT therapycombination therapypediatric DVTpediatric thrombolysispediatric thrombosisthrombolysis

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