Yıl: 2021 Cilt: 8 Sayı: 3 Sayfa Aralığı: 251 - 256 Metin Dili: İngilizce DOI: 10.4274/jpr.galenos.2020.93206 İndeks Tarihi: 21-01-2022

Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience

Öz:
Aim: In this retrospective study, our objective was to evaluate children with arterial or venous thromboembolism, who were treated with tissue plasminogen activator (tPA) in our hospital. Materials and Methods: The medical records of 56 tPA treatments administered to 53 patients with thrombosis in the paediatric intensive care unit and paediatric clinic at Çukurova University, Balcalı Hospital between September 2013 and August 2018, were investigated retrospectively. Results: Thirty-three of the patients were males (58.9%). The median age was 13.5 months (0-203 months). Fifty-two of the patients received low-dose tPA treatment (91.2%) and the mean treatment duration was 63.8±43.3 hours (3-192 hours). Thrombolytic treatment was administered to 38 patients (67.8%) with catheter-related arterial thrombus, to 8 patients (14.3%) with intracardiac thrombus, to 4 patients (7.2%) with pulmonary arterial thrombus, and to 6 patients (10.7%) with deep venous thrombus. No complication was observed in 47 treatments (83.9%). However, 7 patients had minor (12.5%) and 2 patients had major bleeding (3.6%). Recanalization could not be achieved in 8 cases (14.3%) and 4 patients underwent thrombectomy. The use of anticoagulant treatment with tPA did not change the complication rate or the success rate of the recanalization. Conclusion: We determined that low-dose tPA treatment was effective in the treatment of life-, limb- or organ-threatening arterial and venous thromboembolism in children. However, randomized studies with larger sample sizes and control groups are required.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Chan AK, Monagle P. Updates in thrombosis in pediatrics: where are we after 20 years? Hematol Am Soc Hematol Educ Program 2012; 2012:439-44.
  • 2. Polikoff LA, Faustino EV. Venous thromboembolism in critically ill children. Curr Opin Pediatr 2014; 26:286-91.
  • 3. Brotschi B, Hug MI, Kretschmar O, et al. Incidence and predictors of cardiac catheterisation-related arterial thrombosis in children. Heart 2015; 101:948-95.
  • 4. Raffini L, Huang YS, Witmer C, et al. Dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics 2009; 124:1001-8.
  • 5. Setty BA, O’Brien SH, Kerlin BA. Pediatric venous thromboembolism in the United States: a tertiary care complication of chronic diseases. Pediatr Blood Cancer 2012; 59:258-64.
  • 6. Totapally BR, Raszynski A, Khan D, et al. Extremity arterial thromboses in hospitalized children: a national database analysis of prevalence and therapeutic interventions. Pediatr Crit Care Med 2019; 20:154-9.
  • 7. Albisetti M, Schmugge M, Haas R, et al. Arterial thromboembolic complications in critically ill children. J Crit Care 2005; 20:296- 300.
  • 8. Brotschi B, Hug MI, Latal B, et al. Incidence and predictors of indwelling arterial catheter-related thrombosis in children. J Thromb Haemost 2011; 9:1157-62.
  • 9. Newall F, Browne M, Savoia H, et al. Assessing the outcome of systemic tissue plasminogen activator for the management of venous and arterial thrombosis in paediatrics. J Pediatr Hematol Oncol 2007; 29:269-73.
  • 10. Tarango C, Manco-Johnson MJ. Pediatric thrombolysis: a practical Approach. Front Pediatr 2017;5:260.
  • 11. Lyle CA, Sidonio RF, Goldenberg NA. New developments in pediatric venous thromboembolism and anticoagulation, including the target-specific oral anticoagulants. Curr Opin Pediatr 2015; 27:18-25.
  • 12. Ko RH, Michieli C, Lira JL, et al. FondaKIDS II: long-term follow up data of children receiving fondaparinux for treatment of venous thromboembolic events. Thromb Res 2014; 134:643-7.
  • 13. Law C, Raffini L. A guide to the use of anticoagulant drugs in children. Pediatr Drugs 2015; 17:105-14.
  • 14. Kukreja K, Gruppo R, Chima R, Ristagno R, Racadio J. Developing a pediatric endovascular thrombolysis program: a single-center experience. Pediatr Radiol 2013; 43:1024-9.
  • 15. Manco-Johnson MJ, Grabowski EF, Hellgreen M, et al. Recommendations for tPA thrombolysis in children. On behalf of the Scientific Subcommittee on Perinatal and Pediatric Thrombosis of the Scientific and Standardization Committee of the International Society of Thrombosis and Haemostasis. Thromb Haemost 2002; 88:157-8.
  • 16. Monagle P, Chan AKC, Goldenberg NA, et al. Antithrombotic Therapy in Neonates and Children. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141(Suppl 2):e737S-801S.
  • 17. Monagle P, Cuello CA, Augustine C, et al. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv 2018; 2:3292-316.
  • 18. Albisetti M. Thrombolytic therapy in children. Thromb Res 2006; 118:95-105.
  • 19. Wang M, Hays T, Balasa V, et al. Pediatric Coagulation Consortium. Low-dose tissue plasminogen activator thrombolysis in children. J Pediatr Hematol Oncol 2003; 25:379- 86.
  • 20. Manco-Johnson MJ, Nuss R, Hays T, et al. Combined thrombolytic and anticoagulant therapy for venous thrombosis in children. J Pediatr 2000; 136:446-53.
  • 21. Leary SE, Harrod VL, de Alarcon PA, et al. Low-dose systemic thrombolytic therapy for deep vein thrombosis in pediatric patients. J Pediatr Hematol Oncol 2010; 32:97-102.
  • 22. Gupta AA, Leaker M, Andrew M, et al. Safety and outcomes of thrombolysis with tissue plasminogen activator for treatment of intravascular thrombosis in children. J Pediatr 2001; 139:682-8.
APA Yontem A, Leblebisatan G, yildizdas d, ŞAŞMAZ h, Erdem S, demir F, Melek E, Karabay Bayazit A (2021). Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. , 251 - 256. 10.4274/jpr.galenos.2020.93206
Chicago Yontem Ahmet,Leblebisatan Goksel,yildizdas dincer,ŞAŞMAZ hatice,Erdem Sevcan,demir Fadli,Melek Engin,Karabay Bayazit Aysun Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. (2021): 251 - 256. 10.4274/jpr.galenos.2020.93206
MLA Yontem Ahmet,Leblebisatan Goksel,yildizdas dincer,ŞAŞMAZ hatice,Erdem Sevcan,demir Fadli,Melek Engin,Karabay Bayazit Aysun Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. , 2021, ss.251 - 256. 10.4274/jpr.galenos.2020.93206
AMA Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. . 2021; 251 - 256. 10.4274/jpr.galenos.2020.93206
Vancouver Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. . 2021; 251 - 256. 10.4274/jpr.galenos.2020.93206
IEEE Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A "Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience." , ss.251 - 256, 2021. 10.4274/jpr.galenos.2020.93206
ISNAD Yontem, Ahmet vd. "Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience". (2021), 251-256. https://doi.org/10.4274/jpr.galenos.2020.93206
APA Yontem A, Leblebisatan G, yildizdas d, ŞAŞMAZ h, Erdem S, demir F, Melek E, Karabay Bayazit A (2021). Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. The Journal of Pediatric Research, 8(3), 251 - 256. 10.4274/jpr.galenos.2020.93206
Chicago Yontem Ahmet,Leblebisatan Goksel,yildizdas dincer,ŞAŞMAZ hatice,Erdem Sevcan,demir Fadli,Melek Engin,Karabay Bayazit Aysun Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. The Journal of Pediatric Research 8, no.3 (2021): 251 - 256. 10.4274/jpr.galenos.2020.93206
MLA Yontem Ahmet,Leblebisatan Goksel,yildizdas dincer,ŞAŞMAZ hatice,Erdem Sevcan,demir Fadli,Melek Engin,Karabay Bayazit Aysun Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. The Journal of Pediatric Research, vol.8, no.3, 2021, ss.251 - 256. 10.4274/jpr.galenos.2020.93206
AMA Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. The Journal of Pediatric Research. 2021; 8(3): 251 - 256. 10.4274/jpr.galenos.2020.93206
Vancouver Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience. The Journal of Pediatric Research. 2021; 8(3): 251 - 256. 10.4274/jpr.galenos.2020.93206
IEEE Yontem A,Leblebisatan G,yildizdas d,ŞAŞMAZ h,Erdem S,demir F,Melek E,Karabay Bayazit A "Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience." The Journal of Pediatric Research, 8, ss.251 - 256, 2021. 10.4274/jpr.galenos.2020.93206
ISNAD Yontem, Ahmet vd. "Evaluation of Children Receiving Tissue Plasminogen Activator Therapy for Thrombosis: Single Center Experience". The Journal of Pediatric Research 8/3 (2021), 251-256. https://doi.org/10.4274/jpr.galenos.2020.93206