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TPA use of PICC lines

 I am sending this out to find out what other institutions are using nationally to declott their PICC lines. Currently we are using a 1mg of alteplase in a 1ml volume to declott our picc lines.  It is my understanding that this is less than other institutions are using as we are not able to dissolve the fibrin sheath at the tip of the catheter with enough of the tpa due to the lower doseage and volume.  I would like to know what other institutions are using. Any input would be greatly appreciated.

We use Cathflo Activase 2mg

We use Cathflo Activase 2mg diluted in 2.2ml sterile water and instill 2ml in each lumen that is occluded.  I am successful at opening the lines after the 30 min. dwell time about 95% of the time.  (rough estimate). Hope this helps.

Valorie Dunn,BSN, RN, CRNI, PLNC

instructions for use:


We follow the instructions from the company.

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

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