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Clinical outcomes of management of CVAD occlusions
  1. Calvin Peng1,2,
  2. Paul Monagle1,2,3,
  3. Fiona Newall1,2,3,4
  1. 1Department of Paediatrics, The University of Melbourne, Melbourne, Australia
  2. 2Murdoch Childrens Research Institute, Parkville, Australia
  3. 3Clinical Haematology Department, Royal Children's Hospital, Melbourne, Australia
  4. 4Department of Nursing, The University of Melbourne, Australia
  1. Correspondence to Fiona Newall, Clinical Haematology Department, Royal Children's Hospital, Flemington Rd, Parkville, VIC 3052, Australia; fiona.newall{at}


Central venous access device (CVAD) occlusions are commonly treated with tissue plasminogen activator (tPA). Eighty-seven patients with 97 catheters at The Royal Children's Hospital, Melbourne were given tPA as per clinical practice guidelines. Restoration of CVAD patency and long-term CVAD survival were measured. Cumulative CVAD restoration rates for tPA treatment were 68.5% and 78.7% after one and two doses, respectively. A significantly lower rate of successful tPA treatment was found in implantable ports (46.2% compared with 81% for Hickman catheters). CVAD time of survival until non-elective removal for 3 months, 6 months and 12 months was 64%, 57% and 47%, respectively. The authors conclude that tPA is safe and effective in extending the life of occluded CVADs occlusions by months to years but is less effective in implantable ports.

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  • Competing interests None.

  • Ethics approval Ethics approval was granted by The Royal Children's Hospital Ethics Committee, audit approval #CA29102.

  • Provenance and peer review Not commissioned; externally peer reviewed.