Our policy in treating CVC occlusion or withdrawal occlusion is to use 2mg TPA. May repeat a second dose if needed. This is after an assessment is done to determine the cause. In our cancer and long term VAD patients we have treated with a continuous infusion of TPA 4 mg in 50ml normal saline to infuse over 4 hours.THis is to treat the fibrin sheaths/ tails. We have had 100% success with this. It isn't done to often and usually out a the outpt infusion center.
Anyone doing a continuous infusion?