USE OF TISSUE-PLASMINOGEN ACTIVATOR FOR REOPENING OF CLOTTED DIALYSISCATHETERS

The use of central venous catheters as permanent vascular access in ch ronic hemodialysis is complicated by clotting. We have tried a nonalle rgenic thrombolytic agent, tissue plasminogen activator (t-PA), to dis solve catheter luminal thrombosis. Eight patients, 7 in chronic hemodi alysis and 1 treated by immune adsorption had 18 treatments with local ly applied t-PA (2 mg/2 cm3). Fifteen out of 16 treatments with longer bolus dwell than 60 min were successful. No side effects occurred. t- PA dissolves clot formation efficiently and safely, the drug is nonall ergenic and can therefore be given repeatedly.