Combined thrombolytic and anticoagulant therapy for venous thrombosis in children

Manco‐Johnson, Marilyn J.; Nuss, Rachelle; Hays, Taru; Krupski, William C.; Drose, Julia A.; Manco-Johnson, M L

doi:10.1016/s0022-3476(00)90006-4

Cited by 84 publications

(71 citation statements)

References 30 publications

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“…The incidence of clinically significant PTS in children in unknown; reported incidences range from 10% to 60% but comparisons of studies are hampered by a lack of standardization of the evaluation tools and limited follow-up (Manco-Johnson et al, 2000;Monagle et al, 2000;Kuhle et al, 2003). Adaptations of adult PTS scales have been used in paediatric studies to allow assessment in young children and to include specific features of upper limb PTS, e.g.…”

Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

“…The bleeding risk reported in this cohort was low. PTS is a particular concern for long-term morbidity in children who can be expected to live for many decades after a thrombosis (Manco-Johnson et al, 2000;Hausler et al, 2001).…”

Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

“…The Canadian registry found no significant bleeds in 119 children treated for VTE and likewise, no major bleeds occurred in a study where children received UFH and fibrinolytics (Andrew et al, 1994a;Manco-Johnson et al, 2000).…”

Section: Bleedingmentioning

confidence: 99%

“…The authors of this study hypothesise that a higher bleeding rate may be explained by the selection of children to receive UFH who are often more complicated. In the earlier studies cited, the whole group received UFH (Andrew et al, 1994b;Manco-Johnson et al, 2000).…”

Section: Bleedingmentioning

confidence: 99%

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Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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SummaryThe number of children receiving anticoagulation is increasing. Thromboembolic events are associated with significant risk of morbidity and mortality although the optimal management of asymptomatic events remains unclear. Specific challenges in paediatrics include the diagnosis of thrombosis, delivery and monitoring of anticoagulation in a wide range of ages from neonates through to adolescents. The development of the haemostatic system as children age results in changing pathophysiology of thrombosis and response to anticoagulation agents. Although registry and observational studies have provided vital information, specific paediatric, prospective anticoagulation studies have been few and limited in design. The result is that much of current practice is extrapolated from adult studies. Traditional anticoagulants have significant limitations. Both heparin and warfarin are in widespread use but many fundamental questions regarding dose, therapeutic range, efficacy and optimum duration have not been fully answered. Alternative agents, such as direct thrombin inhibitors and the selective anti-factor Xa inhibitor fondaparinux, may have advantages for children. Clinical trials in adults and preliminary data in children are promising but caution should be applied until specific paediatric studies have demonstrated safety and efficacy.

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Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

Section: Morbidity and Mortality Associated With Vte In Childrenmentioning

confidence: 99%

Section: Bleedingmentioning

confidence: 99%

Section: Bleedingmentioning

confidence: 99%

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Aspects of anticoagulation in children

Payne

2010

Br J Haematol

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“…4,5 The use of HBOT has been shown by several investigators to restore a favorable cellular environment for wound healing and support vascular proliferation by increasing the oxygen content of the plasma. 6,7 HBOT is currently widely used for treatment of CO intoxication, arterial gas emboli, compromised skin flaps and grafts, radiation soft tissue necrosis, osteoradionecrosis and chronic non-healing wounds. Siraneci et al 8 report the successful use of adjunctive HBOT in an infant with thrombotic purpura fulminans.…”

Section: Case Presentationmentioning

confidence: 99%

Hyperbaric oxygen in treatment of neonatal arterial thromboembolism of lower extremities

et al. 2006

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Arterial thromboembolism (TE) in the absence of current or recent history of a central catheter is a rare condition in newborn period. We report a case of severe lower extremities arterial TE of unclear etiology in a full-term neonate. By adding hyperbaric oxygenation to thrombolytic and antithrombotic therapy, we achieved improved perfusion of the upper leg tissues, preserving the knee and enabling below-the-knee amputation.

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A Biomimicking and Multiarm Self‐Indicating Nanoassembly for Site‐Specific Photothermal‐Potentiated Thrombolysis Assessed in Microfluidic and In Vivo Models

Liu

Quiñones

Liu

et al. 2023

Adv Healthcare Materials

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Thrombolytic and antithrombotic therapies are limited by short circulation time and the risk of off‐target hemorrhage. Integrating a thrombus‐homing strategy with photothermal therapy are proposed to address these limitations. Using glycol chitosan, polypyrrole, iron oxide and heparin, biomimicking GCPIH nanoparticles are developed for targeted thrombus delivery and thrombolysis. The nanoassembly achieves precise delivery of polypyrrole, exhibiting biocompatibility, selective accumulation at multiple thrombus sites, and enhanced thrombolysis through photothermal activation. To simulate targeted thrombolysis, a microfluidic model predicting thrombolysis dynamics in realistic pathological scenarios is designed. Human blood assessments validate the precise homing of GCPIH nanoparticles to activated thrombus microenvironments. Efficient near‐infrared phototherapeutic effects are demonstrated at thrombus lesions under physiological flow conditions ex vivo. The combined investigations provide compelling evidence supporting the potential of GCPIH nanoparticles for effective thrombus therapy. The microfluidic model also offers a platform for advanced thrombolytic nanomedicine development.

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Combined thrombolytic and anticoagulant therapy for venous thrombosis in children

Cited by 84 publications

References 30 publications

Aspects of anticoagulation in children

Aspects of anticoagulation in children

Hyperbaric oxygen in treatment of neonatal arterial thromboembolism of lower extremities

A Biomimicking and Multiarm Self‐Indicating Nanoassembly for Site‐Specific Photothermal‐Potentiated Thrombolysis Assessed in Microfluidic and In Vivo Models

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