Urokinase infusion restores function of thrombotically-occluded inferior vena cava apheresis catheters refractory to bolus urokinase therapy

William D. Haire, Robert P. Lieberman, Kim Schmit-Pokorny, Margaret Anne Kessinger

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Translumbar inferior vena cava catheters have been shown to be safe and effective in providing venous access for apheresis collection of peripheral blood stem cells for transplantation. Thrombotic occlusion of these catheters can limit their effectiveness for apheresis. While some of these occlusions respond to installation of the 5000 unit "Open-Cath®" dose of urokinase, there are no guidelines for therapy of occluded catheters not responding to this treatment. We have performed low-dose urokinase infusion on 11 IVC apheresis catheters radiographically documented to be occluded by thrombus. These catheters had failed a mean of 1.5-5000 unit boluses of urokinase. Seven catheters underwent urokinase infusion at 40,000 units/ h for 12 h. All had complete restoration of catheter function and 6 had total dissolution of thrombus on post-therapy X-ray. Because of the initial success of the 12 h infusion, we treated 4 catheters with the same dose of urokinase for 6 h. All 4 had complete restoration of catheter function and 2 had total thrombus dissolution on X-ray. No bleeding complications were seen. For occluded IVC apheresis catheters, initial therapy should be the installation of at least one 5000 unit bolus of urokinase. For catheters not responding to this therapy, radiographic evaluation should be conducted. If thrombotic occlusion is found, a 40,000 unit/h infusion of urokinase for 6-12 h can safely salvage catheter function and allow continued apheresis.

Original languageEnglish (US)
Pages (from-to)311-316
Number of pages6
JournalTransfusion Science
Volume12
Issue number4
DOIs
StatePublished - Jan 1 1991

Fingerprint

Blood Component Removal
Urokinase-Type Plasminogen Activator
Inferior Vena Cava
Catheters
Therapeutics
Thrombosis
X-Ray Therapy
Peripheral Blood Stem Cell Transplantation

ASJC Scopus subject areas

  • Immunology
  • Hematology

Cite this

Urokinase infusion restores function of thrombotically-occluded inferior vena cava apheresis catheters refractory to bolus urokinase therapy. / Haire, William D.; Lieberman, Robert P.; Schmit-Pokorny, Kim; Kessinger, Margaret Anne.

In: Transfusion Science, Vol. 12, No. 4, 01.01.1991, p. 311-316.

Research output: Contribution to journalArticle

Haire, William D. ; Lieberman, Robert P. ; Schmit-Pokorny, Kim ; Kessinger, Margaret Anne. / Urokinase infusion restores function of thrombotically-occluded inferior vena cava apheresis catheters refractory to bolus urokinase therapy. In: Transfusion Science. 1991 ; Vol. 12, No. 4. pp. 311-316.
@article{3eaddfd18f0f43b8a542408605adb48e,
title = "Urokinase infusion restores function of thrombotically-occluded inferior vena cava apheresis catheters refractory to bolus urokinase therapy",
abstract = "Translumbar inferior vena cava catheters have been shown to be safe and effective in providing venous access for apheresis collection of peripheral blood stem cells for transplantation. Thrombotic occlusion of these catheters can limit their effectiveness for apheresis. While some of these occlusions respond to installation of the 5000 unit {"}Open-Cath{\circledR}{"} dose of urokinase, there are no guidelines for therapy of occluded catheters not responding to this treatment. We have performed low-dose urokinase infusion on 11 IVC apheresis catheters radiographically documented to be occluded by thrombus. These catheters had failed a mean of 1.5-5000 unit boluses of urokinase. Seven catheters underwent urokinase infusion at 40,000 units/ h for 12 h. All had complete restoration of catheter function and 6 had total dissolution of thrombus on post-therapy X-ray. Because of the initial success of the 12 h infusion, we treated 4 catheters with the same dose of urokinase for 6 h. All 4 had complete restoration of catheter function and 2 had total thrombus dissolution on X-ray. No bleeding complications were seen. For occluded IVC apheresis catheters, initial therapy should be the installation of at least one 5000 unit bolus of urokinase. For catheters not responding to this therapy, radiographic evaluation should be conducted. If thrombotic occlusion is found, a 40,000 unit/h infusion of urokinase for 6-12 h can safely salvage catheter function and allow continued apheresis.",
author = "Haire, {William D.} and Lieberman, {Robert P.} and Kim Schmit-Pokorny and Kessinger, {Margaret Anne}",
year = "1991",
month = "1",
day = "1",
doi = "10.1016/0955-3886(91)90112-G",
language = "English (US)",
volume = "12",
pages = "311--316",
journal = "Transfusion and Apheresis Science",
issn = "1473-0502",
publisher = "Elsevier Limited",
number = "4",

}

TY - JOUR

T1 - Urokinase infusion restores function of thrombotically-occluded inferior vena cava apheresis catheters refractory to bolus urokinase therapy

AU - Haire, William D.

AU - Lieberman, Robert P.

AU - Schmit-Pokorny, Kim

AU - Kessinger, Margaret Anne

PY - 1991/1/1

Y1 - 1991/1/1

N2 - Translumbar inferior vena cava catheters have been shown to be safe and effective in providing venous access for apheresis collection of peripheral blood stem cells for transplantation. Thrombotic occlusion of these catheters can limit their effectiveness for apheresis. While some of these occlusions respond to installation of the 5000 unit "Open-Cath®" dose of urokinase, there are no guidelines for therapy of occluded catheters not responding to this treatment. We have performed low-dose urokinase infusion on 11 IVC apheresis catheters radiographically documented to be occluded by thrombus. These catheters had failed a mean of 1.5-5000 unit boluses of urokinase. Seven catheters underwent urokinase infusion at 40,000 units/ h for 12 h. All had complete restoration of catheter function and 6 had total dissolution of thrombus on post-therapy X-ray. Because of the initial success of the 12 h infusion, we treated 4 catheters with the same dose of urokinase for 6 h. All 4 had complete restoration of catheter function and 2 had total thrombus dissolution on X-ray. No bleeding complications were seen. For occluded IVC apheresis catheters, initial therapy should be the installation of at least one 5000 unit bolus of urokinase. For catheters not responding to this therapy, radiographic evaluation should be conducted. If thrombotic occlusion is found, a 40,000 unit/h infusion of urokinase for 6-12 h can safely salvage catheter function and allow continued apheresis.

AB - Translumbar inferior vena cava catheters have been shown to be safe and effective in providing venous access for apheresis collection of peripheral blood stem cells for transplantation. Thrombotic occlusion of these catheters can limit their effectiveness for apheresis. While some of these occlusions respond to installation of the 5000 unit "Open-Cath®" dose of urokinase, there are no guidelines for therapy of occluded catheters not responding to this treatment. We have performed low-dose urokinase infusion on 11 IVC apheresis catheters radiographically documented to be occluded by thrombus. These catheters had failed a mean of 1.5-5000 unit boluses of urokinase. Seven catheters underwent urokinase infusion at 40,000 units/ h for 12 h. All had complete restoration of catheter function and 6 had total dissolution of thrombus on post-therapy X-ray. Because of the initial success of the 12 h infusion, we treated 4 catheters with the same dose of urokinase for 6 h. All 4 had complete restoration of catheter function and 2 had total thrombus dissolution on X-ray. No bleeding complications were seen. For occluded IVC apheresis catheters, initial therapy should be the installation of at least one 5000 unit bolus of urokinase. For catheters not responding to this therapy, radiographic evaluation should be conducted. If thrombotic occlusion is found, a 40,000 unit/h infusion of urokinase for 6-12 h can safely salvage catheter function and allow continued apheresis.

UR - http://www.scopus.com/inward/record.url?scp=0025812668&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025812668&partnerID=8YFLogxK

U2 - 10.1016/0955-3886(91)90112-G

DO - 10.1016/0955-3886(91)90112-G

M3 - Article

VL - 12

SP - 311

EP - 316

JO - Transfusion and Apheresis Science

JF - Transfusion and Apheresis Science

SN - 1473-0502

IS - 4

ER -