Therapy for thrombotic occlusion of long-term intravenous alimentation catheters

Thrombosis and infection are closely related complications of implanted silastic catheters. A procedure, by which the thrombi are dispersed with urokinase while the catheter remains in situ, was uniformly successful in clearing the line in 20 patients, although in 5 the infusion had to be repeated 24 hr later. Catheter-associated infections are rendered susceptible to antibiotics as the infected thrombotic nidus is lysed and the organisms exposed. In 7 patients, 4 of whom were taking antibiotics, fever and blood cultures became negative. The procedure results in no detectable systemic fibrinolysis or other complications.