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Semin Thromb Hemost 2001; 27(2): 169-174
DOI: 10.1055/s-2001-14077
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Thrombolytic Therapy in Children- Clinical Experiences with Recombinant Tissue-Plasminogen Activator

Ralf Knöfler1 , Jürgen Dinger1 , Maria Kabus1 , Diane Müller1 , Ingrid Lauterbach1 , Edgar Rupprecht2 , Heike Taut-Sack2 , Gerhard Weissbach1
  • 1Department of Pediatrics, Medical Faculty of Technical University Dresden, Dresden, Germany and
  • 2Department of Pediatric Radiology, Medical Faculty of Technical University Dresden, Dresden, Germany
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Publikationsdatum:
31. Dezember 2001 (online)

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ABSTRACT

For the improvement of thrombolytic therapy with recombinant tissue-plasminogen activator (rt-PA) in children, more clinical data are needed. We retrospectively analyzed the clinical course of 20 patients (age ranging from 1 day to 16 years) with venous thrombosis (n = 16), arterial thrombosis (n = 2), and purpura fulminans by meningococcosis (n = 2). The venous thromboses were localized in the iliac-femoral veins (n = 9), brachiocephalic-jugular-subclavian veins (n = 6), and the superior caval vein (n = 1). The arterial occlusions were localized in the abdominal aorta and in the left pulmonary artery. Central venous catheters were of pathogenetic importance in seven cases. The patients were treated with rt-PA for 3 hours to 13 days. The dose ranged between 0.2 and 0.5 mg/kg for the initial bolus and 1.0 to 2.0 mg/kg/d for the continuous infusion. Nineteen patients received simultaneously low-dose unfractionated heparin. Complete clot lysis was detected in 11 cases, a partial lysis in 1, and in 8 patients thrombolytic therapy was not successful. An episode of hematemesis in one patient represented the only serious side effect observed in our study. A systemic decrease in fibrinogen concentration was also rare. In conclusion, thrombolysis with rt-PA represents an effective and safe therapy for children at the dosage used.

KEYWORD

Thrombosis - meningococcosis - thrombolysis - rt-PA - children

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