Increased ventriculostomy infection rate with use of intraventricular tissue plasminogen activator: a single-center observation.

Clin Neurol Neurosurg

Department of Neurosurgery, School of Medicine and Biomedical Sciences, Buffalo, USA; Department of Neurosurgery, Roswell Park Cancer Institute, Buffalo, USA. Electronic address:

Published: November 2013

Objective: Intraventricular tissue plasminogen activator (alteplase) has been advocated for prevention of vasospasm in aneurysmal subarachnoid hemorrhage and treatment of traumatic or spontaneous intraventricular hemorrhage. External ventricular drain (EVD) insertion is often performed to manage increased intracranial pressure and hydrocephalus associated with these disease states. EVD-related ventriculitis is a serious infection with an up to 50% mortality rate.

Methods: We assessed the EVD infection rate in patients receiving intraventricular alteplase over a 12-month period. Patients were divided into intraventricular alteplase and non-intraventricular alteplase groups; ventriculitis rates were compared.

Results: EVDs were placed in 93 patients. Six of 7 (86%) patients who received intraventricular alteplase developed ventriculitis versus 4 of 86 (5%) patients in the non-intraventricular alteplase group (p<0.0001).

Conclusion: Intraventricular alteplase use may increase ventriculitis risk. Currently, we reserve intraventricular alteplase for patients with EVDs obstructed by hematoma accompanied by increased intracranial pressure.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2013.08.018DOI Listing

Publication Analysis

Top Keywords

intraventricular alteplase
12
infection rate
8
intraventricular tissue
8
tissue plasminogen
8
plasminogen activator
8
non-intraventricular alteplase
8
intraventricular
6
alteplase
6
patients
5
increased ventriculostomy
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!