Key result
Catheter-directed tPA via existing venous port resolves large right atrial thrombus after 24 hours.
Why the study?
Does catheter-directed thrombolysis via an existing venous-access port resolve right atrial thrombus in a patient with metastatic cancer?
Case Report (n=1)
No
Does catheter-directed thrombolysis via an existing venous-access port resolve right atrial thrombus in a patient with metastatic cancer?
Catheter-directed thrombolysis via an existing venous-access port may be an effective approach to treat catheter-induced right atrial thrombus.
May offer a feasible option for right atrial thrombus via existing ports in cancer; hypothesis-generating, larger studies needed before adoption.
: Presented is a single-case of a novel technique of catheter-directed thrombolysis via an existing implanted venous-access port for treatment of a right atrial thrombus. : A 51-year-old woman with metastatic colon cancer, being treated with chemotherapy via a MediPort was found to have a large right atrial thrombus (2.8 × 4.7 × 2.3cm) adjacent to the MediPort tip on follow-up chest CT. The patient received three months of anticoagulation without improvement. Due to the location of the thrombus, the patient was treated with continuous infusion of tissue plasminogen activator through the MediPort at a rate of 1mg/hr for 24 hours. : Transthoracic echocardiogram at 24hr demonstrated no visible thrombus. 1 month follow up TTE revealed resolution of RA thrombus. : A catheter-directed thrombolysis is the effective approach to treat a catheter induced thrombus, while lowering the systemic risk of thrombolytic therapy.
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Panesar et al. (2023) conducted a case report in Right atrial thrombus (n=1). Catheter-directed thrombolysis (tissue plasminogen activator) was evaluated on Resolution of right atrial thrombus. Catheter-directed thrombolysis via an existing venous-access port successfully resolved a large right atrial thrombus after 24 hours of continuous tPA infusion.
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