What are thrombolytic regimens for alteplase for treatment of central venous catheter occlusion?

Updated: Aug 04, 2021
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Alteplase is approved by the US Food and Drug Administration (FDA) for clearance of thrombotically occluded CVADs. It is available in a 2 mg/2 mL vial, which suffices to fill most catheter lumens. For patients weighing 30 kg or more, give 2 mg in 2 mL of saline. For those weighing less than 30 kg, fill 100% of the internal lumen volume of the catheter (but do not exceed 2 mg in 2 mL of saline). Leave the agent for 30 minutes to 2 hours, then withdraw it. The dose may be repeated. If this is unsuccessful, 2 mg/50 mL may be infused over 4 hours.

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