title: Clinical outcomes of management of CVAD occlusions.
abstract: Central venous access device (CVAD) occlusions are commonly treated with tissue plasminogen activator (tPA). Eighty-seven patients with 97 catheters at The Royal Children's Hospital, Melbourne were given tPA as per clinical practice guidelines. Restoration of CVAD patency and long-term CVAD survival were measured. Cumulative CVAD restoration rates for tPA treatment were 68.5% and 78.7% after one and two doses, respectively. A significantly lower rate of successful tPA treatment was found in implantable ports (46.2% compared with 81% for Hickman catheters). CVAD time of survival until non-elective removal for 3 months, 6 months and 12 months was 64%, 57% and 47%, respectively. The authors conclude that tPA is safe and effective in extending the life of occluded CVADs occlusions by months to years but is less effective in implantable ports.
authors.affiliation: Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Calvin
authors.initials: C
authors.lastname: Peng
authors.forename: Paul
authors.initials: P
authors.lastname: Monagle
authors.forename: Fiona
authors.initials: F
authors.lastname: Newall
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator