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Research in practice

Effectiveness of urokinase for salvaging occluded central venous access devices

A literature review explores the effectiveness of urokinase in salvaging occluded central venous access devices.

It is estimated 20,000 central venous access devices (CVADs) are inserted each year in the UK (Flood and Flood 2016). Occlusion is a complication occurring in up to 50% of children with long-term CVADs (Verso and Agnelli 2003). An occluded device prevents crucial treatments being delivered.

Fibrinolytic drugs, such as urokinase, are used as a first line of action to clear the blockage, yet the effectiveness of fibrinolytic drugs is uncertain. Salvaging occluded CVADs prevents the patient needing a replacement, which would be inserted as a surgical procedure. Side effects and costs associated with inserting a new CVAD are higher than those for instilling urokinase.


The aim of this literature review was to explore the effectiveness of urokinase in salvaging occluded CVADs.


A literature review using a systematic approach was undertaken. EMBASE and MEDLINE databases were


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