title: Tissue plasminogen activator (alteplase) treatment for femoral artery thrombosis after cardiac catheterisation in infants and children.
abstract: OBJECTIVE
  To determine the efficacy of fibrinolytic therapy with tissue plasminogen activator (alteplase) in infants and children with arterial thrombosis after cardiac catheterisation.
  
  
  METHODS
  Use of alteplase (Actilyse) in a protocol with prospective data collection. Alteplase was administered to infants and children with arterial thrombosis after cardiac catheterisation. A dose of 0.5 mg/kg/h was given continuously via a peripheral vein for the first hour followed by 0.25 mg/kg/h till clot lysis occurred or treatment had to be stopped because of bleeding complications.
  
  
  METHODS
  University hospital, intensive care unit.
  
  
  METHODS
  17 consecutive infants and children with femoral artery thrombosis after cardiac catheterisation between 1 April 1988 and 31 October 1991.
  
  
  METHODS
  Reopening of the vessel.
  
  
  RESULTS
  Complete clot lysis was achieved in 16 of 17 patients within 4-11 hours after the start of treatment. In one patient only partial lysis occurred. After complete lysis rethrombosis developed in one patient 15 hours after the end of treatment. Bleeding complications were seen in nine patients. These were restricted to the arterial puncture site, except for one who showed mild epistaxis. Three patients had to be treated with packed erythrocytes.
  
  
  CONCLUSIONS
  Alteplase was an effective treatment of arterial thrombosis after cardiac catheterisation in infants and children. Further studies are needed to determine whether lower doses will reduce the frequently observed bleeding complications.
authors.affiliation: Department of Paediatrics, University of Graz, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Zenz
authors.forename: W
authors.initials: W
authors.lastname: Muntean
authors.forename: A
authors.initials: A
authors.lastname: Beitzke
authors.forename: G
authors.initials: G
authors.lastname: Zobel
authors.forename: M
authors.initials: M
authors.lastname: Riccabona
authors.forename: A
authors.initials: A
authors.lastname: Gamillscheg
mesh_terms: D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D006493:Heparin; D010959:Tissue Plasminogen Activator