Alteplase for the treatment of midline catheter occlusions: a retrospective, single-cohort descriptive study

Abstract

Abstract Background Despite the increasing popularity of midline catheters, data on the use of alteplase for restoring midline catheter patency is scarce. Aims This study aimed to evaluate off-label use of alteplase for midline catheter occlusions. Method: Adults who received alteplase into a midline catheter between January 2015 and May 2018 within a multi-hospital health system were included in this study. The primary outcome was restoration of infusion or withdrawal function from at least one lumen of a treated midline catheter. Findings Following alteplase administration, withdrawal function was restored in 47% (25/53) of occlusion events, infusion function was restored in 65% (11/17) of complete occlusion events, and infusion or withdrawal function was restored in 58% (31/53) of occlusion events. Only 34% (17/50) of catheters were replaced because of malfunction. Local bleeding was documented in 9% (n=5) of occlusion events after alteplase administration. Conclusion Most midline catheter occlusions treated with alteplase demonstrated restoration of infusion or withdrawal function.