Low-dose, once-daily, intraclot injections of alteplase for treatment of acute deep venous thrombosis.

Purpose: To evaluate the safety and efficacy of once-daily intraclot injections of low doses (≤ 10 mg) of tissue plasminogen activator (tPA) for thrombolysis of venous thrombosis.

Materials And Methods: In prospective studies, 33 patients with subclavian, jugular, and central venous thrombosis (SJ-CVT) (all but two cases associated with central catheters) were treated once a day with ≤ 4 mg/day of tPA, and 30 patients with acute deep vein thrombosis of the lower extremity (DVT-LE) < 14 days old were treated once a day with ≤ 10 mg/leg/day of tPA by intraclot "lacing" of thrombus without continuous infusions of tPA.

Results: Patency was restored in 26 (79%) of 33 patients with SJ-CVT using an average total dose of 7.

A prospective evaluation of antral follicle function in women with 46,XX spontaneous primary ovarian insufficiency.

Objective: To assess ovarian follicle function in women with 46,XX spontaneous primary ovarian insufficiency.

Design: Case-control with nested prospective cohort.

Setting: Clinical Research Center, National Institutes of Health.

Deep vein thrombosis of lower extremity: direct intraclot injection of alteplase once daily with systemic anticoagulation--results of pilot study.

Purpose: To prospectively evaluate the outcome of patients with acute deep vein thrombosis (DVT) of the lower extremity treated with "lacing" of the thrombus with alteplase (recombinant tissue plasminogen activator, or rTPA).

Materials And Methods: This HIPAA-compliant study was approved by the Institutional Review Board of the National Heart, Lung, and Blood Institute and was funded by the National Institutes of Health. After giving written consent, 20 patients with first-onset acute DVT were treated with direct intraclot lacing of the thrombus with alteplase (maximum daily dose, 50 mg per leg per day; maximum of four treatments) and full systemic anticoagulation.