Urokinase Therapy for Silastic Catheter-Induced Intravascular Thrombi in Infants and Children

Curnow, Adrian; Idowu, Jire; Behrens, Elizabeth; Toomey, Frances B.; Georgeson, Keith E.

doi:10.1001/archsurg.1985.01390350023006

Cited by 41 publications

(17 citation statements)

References 17 publications

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“…This suggests that the Permcath catheter is well tolerated and does not require systemic anticoagulation. The rate of malfunc tion of the Permcath catheter (14%) is similar to that reported with other central catheters, and also the use of heparin and fibrinolytic agents is as widespread as for other catheters [35].…”

Section: Discussionsupporting

confidence: 78%

Use of Permcath (Quinton) Catheter in Uraemic Patients in Whom the Creation of Conventional Vascular Access for Haemodialysis Is Difficult

Pourchez

Morinière²,

Fournier³

et al. 1989

Nephron

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During the last 4 years, the Permcath Quinton double-lumen silicone catheter was inserted into the internal jugular vein of 57 uraemic patients with difficulty for creating conventional vascular access for haemodialysis. In 4 patients, with definitive contraindication of conventional vascular access, this catheter still permits haemodialysis after a duration of 8–25 months. In 25 further patients with terminal uraemia, but poor vein system, it allowed the maturation of an arteriovenous fistula after 2–14 months of use. In 17 patients already on chronic haemodialysis, but who lost abruptly their vascular access (15 grafts and 2 arteriovenous fistulae), it allowed a new arteriovenous fistula to mature in 16 cases after a mean duration of 7.3 ± months. In 5 patients with short life expectancy because of neoplasia, it allowed to dialyse them until their death which occured after 6.5 ± 2.2 months. In 6 patients with acute renal failure and haemostasis problems, it allowed to perform not only dialysis, but also plasmapheresis in 3 and parenteral nutrition in 3 other cases. The complications were the following: sepsis (n = 3); episodes of hypocoagulability due to inadvertent injection of heparin stored in the lumen (n = 2), thrombosis of the lumen (n = 3), and insufficient flow (n = 6). In no case these complications prevented continuation of haemodialysis. The catheter had to be removed in 2 cases because of septis and in 1 case because of insufficient flow. In 3 cases the catheter had to be replaced because of thrombosis and in 1 case because of laceration. These complication rates are, however, fewer than those reported in the literature for arteriovenous shunts or rigid subclavian and femoral catheters. The Permcath catheter seems, therefore to be the method of choice for immediated vascular access in patients in whom the creation of conventional vascular access is difficult.

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Section: Discussionsupporting

confidence: 78%

Use of Permcath (Quinton) Catheter in Uraemic Patients in Whom the Creation of Conventional Vascular Access for Haemodialysis Is Difficult

Pourchez

Morinière²,

Fournier³

et al. 1989

Nephron

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“…Once again, tPA is the most commonly used agent; however, use of urokinase and recombinant urokinase (rUK) have also been reported. [239][240][241][242][243][244][245][246][247][248] …”

Section: Adverse Effectsmentioning

confidence: 99%

“…Both tPA and urokinase have been shown to restore patency in 50% to 90% of CVADs; tPA has been increasingly used relative to urokinase in children during the past decade in doses ranging from 0.1 to 2 mg. Studies have included few neonates. [239][240][241][242][243][244][245][246][247][248] There are no published studies comparing the use of intermittent local thrombolysis as primary prophylaxis for CVAD patency. There are no studies that consider the use of systemic heparin or LMWH as primary prophylaxis for CVADs in neonates as distinct from older children.…”

Section: Thromboprophylaxis For Stage 1 Norwood Proceduresmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,269

559

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“…When repeated urokinase infusions were unsuccessful, they were followed by catheter removal. 8,17,21,23 …”

Section: Effect Of Treatment and Prophylaxis On The Rates Of Thrombosismentioning

confidence: 99%

Thromboembolism in Infants and Children With Gastrointestinal Failure Receiving Long‐Term Parenteral Nutrition

Kakzanov

Monagle

Chan

2008

J Parenter Enteral Nutr

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Thromboembolism is an established complication of long-term parenteral nutrition (PN) administration which requires central venous lines in the pediatric population. Predisposing factors that increase the risk of thrombosis, as well as prophylaxis and treatment guidelines in this specific population, are not clearly defined. We performed a computerized search of PubMed, OVID databases, and pertinent articles from reference lists of related review papers. This review summarizes currently available data on the rates of thromboembolism in the pediatric population receiving long-term PN and concludes that control of factors such as location of catheter, duration of nutrition support, and prophylaxis with heparin or anticoagulants may reduce the rates of thrombosis in this patient population, although most data on the matter are inconclusive.

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Urokinase Therapy for Silastic Catheter-Induced Intravascular Thrombi in Infants and Children

Cited by 41 publications

References 17 publications

Use of Permcath (Quinton) Catheter in Uraemic Patients in Whom the Creation of Conventional Vascular Access for Haemodialysis Is Difficult

Use of Permcath (Quinton) Catheter in Uraemic Patients in Whom the Creation of Conventional Vascular Access for Haemodialysis Is Difficult

Antithrombotic Therapy in Neonates and Children

Thromboembolism in Infants and Children With Gastrointestinal Failure Receiving Long‐Term Parenteral Nutrition

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