Weekly prophylactic urokinase instillation in tunneled central venous access devices

Charles E. Ray, Sadashiv S. Shenoy, Philip L. McCarthy, Karen A. Broderick, John A. Kaufman

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

PURPOSE: To determine the safety and efficacy of weekly prophylactic urokinase therapy in tunneled central venous access devices (VADs). MATERIALS AND METHODS: A prospective, randomized study was performed in 105 patients who underwent tunneled VAD placement between March 1997 and April 1998. The patients were randomized to receive either twice-daily heparin flushes (14 heparin flushes per week; group A, n = 52) or twice-daily heparin flushes with once-weekly urokinase (UK) instillation (13 heparin flushes, one UK flush per week; group B, n = 53). Patients were followed up by examination and/or interview at 1, 3, and 6 months for signs and symptoms of delayed catheter-related complications. RESULTS: The total number of indwelling catheter-days was similar between groups (5,450 in group A, 5,276 in group B). The total number of infectious complications and fibrin sheaths formed was greater for group A (n = 11; 21.1%) than group B (n = 3; 5.7%) (P = .02). There were no side effects noted from the prophylactic UK administrations. CONCLUSION: Prophylactic UK is advantageous in preventing delayed catheter- related complications.

Original languageEnglish (US)
Pages (from-to)1330-1334
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume10
Issue number10
DOIs
StatePublished - Jan 1 1999

Keywords

  • Catheters and catheterization, central venous access
  • Central venous access
  • Urokinase

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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