[Urokinase in the management of occluded PICC lines].
OBJECTIVE
To determine the efficacy and safety of urokinase in the management of occluded PICC lines.


METHODS
A total of 587 PICC lines were placed over an 11 month period. During this period, 28 PICC lines (4.8%) became occluded: 12 occluded PICC lines were successfully managed by simple flushing with normal saline while 16 PICC lines were thrombolyzed with urokinase.


RESULTS
After urokinase, 93.8% (15/16) of occluded PICC lines were completely patent. A single infusion of urokinase, 20,000 IU over 30 minutes, was used in all cases. No secondary occlusion or complication was noted after urokinase.


CONCLUSIONS
Urokinase is effective and safe to restore patency to occluded PICC lines. The procedure is simple, and could be performed at the bedside by nursing staff after medical prescription. It is an alternative to over the wire PICC line exchange, that could reduce the risk of complication related to manipulations, patient discomfort and cost.
Service de Radiologie, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05. cyril.muller@ap-hm.fr
C
C
Muller
A
A
Jacquier
A
A
Varoquaux
F
F
Cohen
G
G
Louis
J Y
JY
Gaubert
G
G
Moulin
J M
JM
Bartoli
V
V
Vidal
D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000295:instrumentation; D002408:Catheters, Indwelling; D004867:Equipment Design; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011140:Polyurethanes / Q000737:chemistry; D012449:Safety; D012828:Silicones / Q000737:chemistry; D012965:Sodium Chloride / Q000627:therapeutic use; D013927:Thrombosis / Q000517:prevention & control*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D011140:Polyurethanes; D012828:Silicones; D012965:Sodium Chloride; D014568:Urokinase-Type Plasminogen Activator