Tenecteplase in the treatment of thrombosed hemodialysis grafts.
A pilot study was carried out to prospectively evaluate the efficacy and safety of Tenecteplase (TNKase) using a modified 'lyse and wait" technique with percutaneous transluminal angioplasty (PTA) to treat thrombosed hemodialysis arteriovenous grafts (AVG)s. Seven patients with eight hemodialysis AVGs were treated and followed up to 1 year. Dosing included 1 mg TNKase and 3,000-4,000 U of heparin. Technical and clinical success rates were 100% and 88%, respectively. No major complications occurred. Primary patency rates at 30, 90, and 180 days were 62%, 50%, and 33%, respectively. TNKase, used in this fashion, may be comparable to alteplase and reteplase for safe and effective thrombolysis of PTFE dialysis grafts.
Department of Radiology, Mount Sinai Medical Center, New York, NY 10029, USA. abigailfalk123@pol.net
Abigail
A
Falk
Kathy
K
Harbour
D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation*; D000077785:Tenecteplase; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014654:Vascular Patency
D005343:Fibrinolytic Agents; D011138:Polytetrafluoroethylene; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase