Document Detail

Thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children.
MedLine Citation:
PMID:  19493417     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Femoral artery thrombosis is one of the most common complications of catheterizations in infants and young children. This study was conducted to investigate the feasibility and effectiveness of thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children. METHODS: Thrombolytic therapy with urokinase was carried out in children with femoral artery thrombosis after left cardiac catheterization. Each patient was given a bolus injection of heparin (100 U/kg). A bolus of urokinase (30,000 - 100,000 U) was injected intravenously, and then a continuous infusion of 10 000 - 50 000 U/h was administered. Transcatheter thrombolysis was performed once previous procedures failed. RESULTS: Eight patients (aged (3.1 +/- 2.3) years (8 months to 7 years), body weight (13.1 +/- 4.2) kg (7 to 20 kg)) presented lower limbs ischemia after left cardiac catheterizations was performed. Seven patients accepted thrombolytic therapy with urokinase. In 5 patients, peripheral intravenous thrombolysis was successful with restoration of a normal pulse. In the other 3 cases, peripheral intravenous thrombolysis failed, followed by successful transcatheter thrombolysis. The average duration of therapy was (7.25 +/- 5.31) hours (1 - 17 hours). The average doses of heparin and urokinase were (1600 +/- 723) U (800 - 3000 U) and (268 571 +/- 177 240) U (50 000 - 500 000 U), respectively. There were no statistically significant differences in partial thromboplastin time before and during urokinase therapy ((40.6 +/- 22.3) to (49.9 +/- 39.2) seconds). However, the prothrombin time was significantly longer ((12.7 +/- 2.58) to (48.1 +/- 18.6) seconds, P < 0.05). Patency of the target vessel was evaluated in all the patients for 2 weeks and no occlusion recurred. CONCLUSION: Thrombolytic therapy with urokinase is a safe and useful modality in children with femoral artery thrombosis after left cardiac catheterization.
Qiong Liu; Chao-wu Yan; Shi-hua Zhao; Shi-liang Jiang; Zhong-ying Xu; Lian-jun Huang; Jian Ling; Hong Zheng; Yun Wang
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Chinese medical journal     Volume:  122     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-06-04     Completed Date:  2009-10-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  931-4     Citation Subset:  IM    
Department of Radiology, Cardiovascular Institute, Wai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
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MeSH Terms
Child, Preschool
Femoral Artery / pathology*,  radiography
Fibrinolytic Agents / therapeutic use*
Heart Catheterization / adverse effects*
Heparin / therapeutic use*
Thrombolytic Therapy / methods*
Thrombosis / drug therapy*,  etiology,  radiography
Treatment Outcome
Urokinase-Type Plasminogen Activator / therapeutic use*
Reg. No./Substance:
0/Fibrinolytic Agents; 9005-49-6/Heparin; EC Plasminogen Activator

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