title: [Fibrinolytic treatment of superior vena cava syndrome, a complication of a central venous catheter].
abstract: Central venous catheterization plays a major role in anesthesia and intensive care medicine. Catheter-induced thrombosis, a common complication, develops in 15-47% of cases. A possible sequela is the occlusion of a large central vein; one early sign is edema of the upper extremities or face. Although complete occlusion of a central vein appears to be rare, this complication should be recognized in view of the extensive use of central venous catheters today. We report a case of severe superior vena cava syndrome that developed after catheterization of the right internal jugular vein. Fibrinolytic treatment using streptokinase and urokinase proved to be successful. A dose of 100,000 units/h was chosen for each agent, and heparin was added during urokinase therapy. Profound clinical improvement was observed after a few hours. Bleeding complications did not occur during the 4 days of treatment.
authors.affiliation: Abteilung für Anaesthesie und Operative Intensivmedizin des Krankenhauses Itzehoe.
authors.forename: J
authors.initials: J
authors.lastname: Wolters
authors.forename: H
authors.initials: H
authors.lastname: Berg
authors.forename: T
authors.initials: T
authors.lastname: Zeidler
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013300:Streptokinase / Q000627:therapeutic use; D013479:Superior Vena Cava Syndrome / Q000188:drug therapy / Q000209:etiology*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
vernacular_title: Lysetherapie des Vena-cava-superior-Syndroms, einer Komplikation des zentralvenösen Katheters.