Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study; [Çocuklarda Sistemik Rekombinant Doku Plazminojen Aktivatörü ile Tromboliz: Çok Merkezli Bir Retrospektif Çalışma]

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dc.contributor.authorZengin E.
dc.contributor.authorSarper N.
dc.contributor.authorErdem A.Y.
dc.contributor.authorAl I.O.
dc.contributor.authorEvim M.S.
dc.contributor.authorYaralı N.
dc.contributor.authorBelen B.
dc.contributor.authorAkçay A.
dc.contributor.authorYıldırım A.T.
dc.contributor.authorKarapınar T.H.
dc.contributor.authorGüneş A.M.
dc.contributor.authorGelen S.A.
dc.contributor.authorÖren H.
dc.contributor.authorOlcay L.
dc.contributor.authorBaytan B.
dc.contributor.authorGülen H.
dc.contributor.authorÖztürk G.
dc.contributor.authorOrhan M.F.
dc.contributor.authorOymak Y.
dc.contributor.authorAkpınar S.
dc.contributor.authorTüfekçi Ö.
dc.contributor.authorAlbayrak M.
dc.contributor.authorGüneş B.T.
dc.contributor.authorCanpolat A.
dc.contributor.authorÖzbek N.
dc.date.accessioned2024-07-22T08:06:24Z
dc.date.available2024-07-22T08:06:24Z
dc.date.issued2021
dc.description.abstractObjective: This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods: Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results: Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion: Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding. © 2021, Turkish Society of Hematology. All rights reserved.
dc.identifier.DOI-ID10.4274/tjh.galenos.2021.2021.0038
dc.identifier.issn13007777
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/13498
dc.language.isoEnglish
dc.publisherTurkish Society of Hematology
dc.rightsAll Open Access; Gold Open Access
dc.subjectAdolescent
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectHumans
dc.subjectInfant
dc.subjectInfant, Newborn
dc.subjectRetrospective Studies
dc.subjectThrombolytic Therapy
dc.subjectThrombosis
dc.subjectTissue Plasminogen Activator
dc.subjectanticoagulant agent
dc.subjectbilirubin
dc.subjectenoxaparin
dc.subjectfibrinogen
dc.subjectfresh frozen plasma
dc.subjectheparin
dc.subjectprogesterone
dc.subjecttissue plasminogen activator
dc.subjecttissue plasminogen activator
dc.subjectadolescent
dc.subjectanaphylaxis
dc.subjectanticoagulant therapy
dc.subjectartery thrombosis
dc.subjectArticle
dc.subjectbacteremia
dc.subjectBehcet disease
dc.subjectbleeding
dc.subjectblood clot lysis
dc.subjectbone marrow biopsy
dc.subjectbronchiolitis
dc.subjectchild
dc.subjectchildhood
dc.subjectchronic lung disease
dc.subjectcontrolled study
dc.subjectdeep vein thrombosis
dc.subjectDown syndrome
dc.subjectdrug megadose
dc.subjectepilepsy
dc.subjecterythrocyte transfusion
dc.subjectFanconi anemia
dc.subjectgastrointestinal hemorrhage
dc.subjectheart rate
dc.subjecthematologist
dc.subjecthemodialysis
dc.subjecthuman
dc.subjecthyperhomocysteinemia
dc.subjecthyperlipidemia
dc.subjectintracardiac thrombosis
dc.subjectischemic heart disease
dc.subjectlarynx edema
dc.subjectleukemia
dc.subjectleukocyte count
dc.subjectlow drug dose
dc.subjectlung embolism
dc.subjectmastoiditis
dc.subjectmucocutaneous lymph node syndrome
dc.subjectmultiple sclerosis
dc.subjectnephrotic syndrome
dc.subjectnewborn
dc.subjectobesity
dc.subjectpediatric patient
dc.subjectpercutaneous thrombectomy
dc.subjectplatelet count
dc.subjectpropionic acidemia
dc.subjectprothrombin time
dc.subjectpyelonephritis
dc.subjectrash
dc.subjectrecanalization
dc.subjectretrospective study
dc.subjectsystemic thrombolysis
dc.subjectthrombus
dc.subjecturticaria
dc.subjectclinical trial
dc.subjectfibrinolytic therapy
dc.subjectinfant
dc.subjectmulticenter study
dc.subjectpreschool child
dc.subjectthrombosis
dc.titleThrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study; [Çocuklarda Sistemik Rekombinant Doku Plazminojen Aktivatörü ile Tromboliz: Çok Merkezli Bir Retrospektif Çalışma]
dc.typeArticle

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