title: Thrombolytic Therapy Using Urokinase for Management of Central Venous Catheter Thrombosis.
abstract: OBJECTIVE
  The management of central venous catheters (CVCs) and catheter thrombosis vary among centers, and the efficacy of the methods of management of catheter thrombosis in CVCs is rarely reported. We investigated the efficacy of bedside thrombolysis with urokinase for the management of catheter thrombosis.
  
  
  METHODS
  We retrospectively reviewed data from patients who had undergone CVC insertion by a single surgeon in a single center between April 2012 and June 2014. We used a protocol for the management of CVCs and when catheter thrombosis was confirmed, 5,000 U urokinase was infused into the catheter.
  
  
  RESULTS
  A total of 137 CVCs were inserted in 126 patients. The most common catheter-related complication was thrombosis (12, 8.8%) followed by infection (8, 5.8%). Nine of the 12 patients (75%) with catheter thrombosis were recanalized successfully with urokinase. The rate of CVC recanalization was higher in the peripherally inserted central catheter (PICC) group (87.5%) than the chemoport group (50%). Reintervention for catheter-related thrombosis was needed in only 2.2% of patients when thrombolytic therapy using urokinase was applied. Age <60 years (P=0.035), PICC group (P=0.037) and location of the catheter tip above the superior vena cava (P=0.044) were confirmed as independent risk factors for catheter thrombosis.
  
  
  CONCLUSIONS
  Thrombolysis therapy using urokinase could successfully manage CVC thrombosis. Reintervention was rarely needed when a protocol using urokinase was applied for the management of CVC thromboses.
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Jung Tack
authors.initials: JT
authors.lastname: Son
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Min
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Pyong Wha
authors.initials: PW
authors.lastname: Choi
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Tae Gil
authors.initials: TG
authors.lastname: Heo
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Chul-Nam
authors.initials: CN
authors.lastname: Kim
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Hong-Yong
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Yi
authors.affiliation: Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Lee
authors.affiliation: Departments of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Roh
keywords: Central venous catheters; Thrombosis; Urokinase-type plasminogen activator