Asra Khan1, Srinath Gowda, Dhaval Parekh, Athar M Qureshi. 1. The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin Street, West Tower, 19th Floor, Suite 19345-C, Houston, TX 77030 USA. axkhan2@texaschildrens.org.
Abstract
OBJECTIVES: Acute vascular thrombosis is associated with significant morbidity and mortality in children. Traditional therapies with angioplasty and manual aspiration thrombectomy are described in the pediatric population; however, data regarding the use of ultrasound-assisted catheter-directed thrombolysis in a pediatric hospital are lacking. METHODS: All patients treated at our center with ultrasound-assisted catheter-directed thrombolysis from 2014-2018 were reviewed. RESULTS: Ten patients with systemic venous (n = 5), pulmonary artery (n = 4), and systemic arterial (n = 1) were treated (20 total vessels), including 2 adults post Fontan palliation. The median age was 11.2 years (range, 9 months to 34.2 years) and median weight was 46.6 kg (range, 6.81-01.6 kg). Therapy was not completed in 1 patient. Significant improvement in clot burden/symptomatic improvement was seen in 8 patients (no improvement seen in 1 patient with acute and chronic thrombosis). There were no major bleeding or neurologic complications related to therapy. CONCLUSIONS: The use of ultrasound-assisted catheter-directed thrombolysis in a pediatric center is a valuable modality for treating acute thrombosis with an acceptable safety profile.
OBJECTIVES: Acute vascular thrombosis is associated with significant morbidity and mortality in children. Traditional therapies with angioplasty and manual aspiration thrombectomy are described in the pediatric population; however, data regarding the use of ultrasound-assisted catheter-directed thrombolysis in a pediatric hospital are lacking. METHODS: All patients treated at our center with ultrasound-assisted catheter-directed thrombolysis from 2014-2018 were reviewed. RESULTS: Ten patients with systemic venous (n = 5), pulmonary artery (n = 4), and systemic arterial (n = 1) were treated (20 total vessels), including 2 adults post Fontan palliation. The median age was 11.2 years (range, 9 months to 34.2 years) and median weight was 46.6 kg (range, 6.81-01.6 kg). Therapy was not completed in 1 patient. Significant improvement in clot burden/symptomatic improvement was seen in 8 patients (no improvement seen in 1 patient with acute and chronic thrombosis). There were no major bleeding or neurologic complications related to therapy. CONCLUSIONS: The use of ultrasound-assisted catheter-directed thrombolysis in a pediatric center is a valuable modality for treating acute thrombosis with an acceptable safety profile.