Thrombolysis, particularly with alteplase, appears to be effective and likely safe for treating occluded central venous catheters in children with cancer, according to a meta-analysis.

Thrombotic occlusion occurs in up to 40% of central venous catheters implanted in children.

Fibrinolytic therapy has been used for more than 20 years to treat thrombotic occlusion, but protocols for administration of thrombolytic agents in children with cancer are generally empirical and have been extrapolated from adult guidelines.

Dr Ana Cristina Carvalho da Costa and colleagues at the University of Brasilia, Brazil, evaluated the interventions used to treat thrombotic events, involving long-term use of central venous catheters in children with cancer, in their systematic review of 10 studies — six of which satisfied criteria for meta-analysis.