Evaluation and treatment of intracardiac thrombus in ten neonates

Use of thrombolytic agents to treat neonatal thrombosis in clinical practice

“…Sixteen studies were retrospective, and two were prospective. Several studies reported the use of more than one thrombolytic agent: 12 studies used tPA [13][14][15][16][17][18][19][20][21][22][23][24], seven used streptokinase [14,21,[25][26][27][28][29] and four used URK [14,27,28,30]. A total of 115 neonates were treated exclusively with tPA, 50 with streptokinase and 15 with URK.…”

“…The average risk of bleeding and mortality with thrombolysis was high at 23 and 13%, respectively. This study draws attention to the need for larger prospective, well [14] tPA 0.02-0.5 N/A 9 h-30 days No Farnoux (1998) [15] tPA 0.3 0.1 3h Yes Weiner (1998) [16] tPA 0.1-0.5 0.5 6-39h No Hartmann (2001) [17] tPA 0.2 0.7 1 -5 days Yes Wang (2003) [18] tPA 0.03-0.5 N/A 3-48h Yes Ade-Ajayi (2008) [19] tPA 0.25-0.5 N/A 6h Yes Demirel (2011) [20] tPA 0.2 N/A 6 days No Aydin (2013) [21] tPA 0.1-0.6 N/A 1 -6 days No Olgun (2014) [22] tPA 0.01 -0.5 N/A 4-58h Yes Alvarez (2017) [23] tPA N/A N/A N/A Yes Kara (2019) [24] tPA 0.06-0. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.…”

“…conducted, cohort studies or comparative, randomized trials to clearly determine the efficacy and safety of thrombolytic agents in the management of neonatal thrombosis. [18] tPA 9 1 (11.1) 0 (0) Ade-Ajayi (2008) [19] tPA 8 N/A N/A Demirel (2011) [20] tPA 8 0 (0) 0 (0) Aydin (2013) [21] tPA 15 10 (66.7) 7 (46.7) Olgun (2014) [22] tPA 10 1 (10.0) 1 (10.0) Alvarez (2017) [23] tPA 11 4 (36.4) 1 (9.1) Kara (2019) [24] tPA 5 1 (20.0) 2 (40.0) LeBlanc (1986) [25] SK 5 1 (20.0) 1 (20.0) Richardson (1988) [26] SK 5 0 (0) 0 (0) Strife (1988) [27] SK 4 3 (75.0) 0 (0) Nowak-Go ¨ttl (1997) [14] SK 2 1 (50.0) N/A Hausler (1999) [28] SK 1 1 (100) 0 (0) Cheah (2001) Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.…”

“…Thrombolysis was discontinued when the clot was completely lysed or when the physician deemed the therapeutic attempt to be unsuccessful [18]. Recent studies (2001 -2019) used doppler ultrasonography [14][15][16]28,29] or echocardiography based on thrombosis location [17,20,22,24], while older studies (1986)(1987)(1988) Use of thrombolytic agents in neonates Leong et al 195 Fig. 1 PRISMA flow diagram of articles retrieved and selected for review.…”

Intrauterine Upper Extremity Thrombosis Successfully Treated with Recombinant Tissue Plasminogen Activator, Enoxaparin and Collagenase

“…In recent years, rt-PA has been used more commonly for the treatment of neonatal thrombosis. In one of the largest series involving 17 cases of neonatal thrombosis, Demirel et al [12,20] reported successful results with rt-PA therapy in 10 patients without any side effects. rt-PA has also been shown to be of benefit for the treatment of resistant fungal infections associated with intracardiac thrombus [21].…”