BMC Cancer 2006, 6:103 http://www.biomedcentral.com/1471-2407/6/103 FFiibgruinroely1tic System Fibrinolytic System. tion at 1100 g for 10 minutes in a sterile syringe. Next, the combination of autologous plasma and r-UK were slowly mixed for 2 minutes within a 5 ml- syringe before applica- tion. The combination was slowly instilled, whereby a volume slightly above the CVP volume was injected. Thirty minutes after instillation, success was assessed by attempting to aspirate the combination and residual clot with an empty, sterile syringe. Up to three further attempts of aspiration were made. If the aspiration was successful, the catheter lumen was immediately flushed with 10 ml sodium chloride and/or heparin. Informed consent was obtained from patients, and, if necessary, from parents, as approved by the Institutional Ethical Committee. Results We report on five patients with an CVP occlusion that could not be managed by routine procedures. All patients Table 1: Patient characteristics. had internal jugular CVPs, which had all been implanted in a surgical unit. The indications for CVP placement were regular infusion of plasma products, chemotherapy and antibiotics. We tested the new method described in this paper as a last resort before catheter replacement. All instillations resulted in successful reestablishment of cath- eter function after approximately 60 minutes of uroki- nase/plasma instillation. No patient experienced adverse effects during or after instillation. No bleeding complica- tions occurred. The entire management procedure was easy to perform and well tolerated. In one case the instil- lation of urokinase and plasma failed. The explanted CVP showed that a silicon particle, which had originated dur- ing puncture, had occluded the CVP. Initials NK AH HR MA BH Age (years) 6 3 67 51 53 Diagnosis Hemophilia Hemophilia Hepatocellular Carcinoma Colon Carcinoma Mammary Carcinoma Therapy Factor VIII Factor VIII Fluorouracil, Folic Acid Fluorouracil, Folic Acid Fluorouracil, Doxorubicin Page 2 of 3 (page number not for citation purposes)