The Open Cardiovascular Imaging Journal

2011, 3 : 4-5
Published online 2011 March 02. DOI: 10.2174/1876538601103010004
Publisher ID: TOCARIJ-3-4

Efficacy of Local Delivery of Recombinant Tissue Plasminogen Activator for Vein Thromboembolic Syndrome

Sumiko Sato , Yoichi Nakamura and Makoto Suzuki
Department of Cardiology, Ehime Prefectural Central Hospital, 83, Kasuga, Matsuyama, Ehime, 790- 0024, Japan.

ABSTRACT

Tissue plasminogen activator (tPA) is a potent thrombolytic agent and as a consequence, bleeding is a major side effect associated with its use. We here describe a 72 year-old woman with a single kidney who was admitted to our hospital because of renal trauma associated with an accident. A large thrombus associated with the central venous line developed close to the wall of the inferior vena cava two weeks after embolization. To manage this complication, we locally delivered 6350 IU/Kg of recombinant tPA (monteplase) through a pulse infusion catheter. This represents only one-half to one-quarter of the usual dose of tPA. One day after this local delivery, the thrombus had disappeared with no bleeding complications despite sub-acute sub-cortical hematoma of the injured kidney. We propose that local delivery of small amounts of recombinant tPA into thrombi may mediate efficient thrombolysis with less bleeding complications as a side effect.

Keywords:

Catheter, pulse infusion, thrombus, thrombolysis.