We have not had trouble until just recently with getting Urokinase for catheters, and now need to start using TPA. Does someone out there have a protocol they would be willing to send? If so, please either fax to (360)428-8276 or e-mail TDearing@affiliatedhealth.org. Thank you, Ruth Hyde

Contact Genetech, Inc. at (650)225-1000. they should be able to provide you with the information you need. The use of their drug Activase ( Alteplase) for treating thrombosed central venous catheters (CVC) is an off label application, but they do have information to share that might be helpful in developing a protocol to use the product in this way.

You might want to obtain a copy of the following reference documenting a study done in 1994 comparing the use of Urokinase and t-PA for use in treated thrombosed CVC.

" Urokinase vs. Recombinant Tissue Plasminogen Activator in Thrombosed Central Venous Catheters : A Double-Blinded, Randomized Trial"; Haire WD, Atkinson JB, Stephens LC, Kotulak GD; Journal of the Internaional Society of Thrombosis and Haemostasis, Vol. 72, No. 4,pp. 543-547, October 1994.

Dr. Haire is in the Department of Internal Medicine at the University of Nebraska in Omaha ( or at least he was in 1994 per the article).

Genetech may be able to provide you with this article since the study was supported by a grant from them.

Good luck !

We also have found difficulty obtainimg urokinase and have recently started using acteplase for difficult lines. If I get the chance I will email our protocol.