In the case series reviewed, duration of therapy ranged from 1 hour to 14 days. Heparin may be administered after alteplase use to avoid recurrence of thrombus formation, but the efficacy and safety of this regimen has not been thoroughly evaluated in children. 3 Summary With concerns over the safety and availability of urokinase, alteplase has found a greater role in pediatric patients requiring thrombolysis. Alteplase offers the advantages of more localized effects than other thrombolytics and a short duration of effect. While the success of alteplase therapy has been well documented, the risk of bleeding complications is still a great concern.
More experience is needed to further define the benefits and risks of alteplase therapy in children.
References Levy M, Benson LN, Burrows PE, et al. Tissue plasminogen activator for the treatment of thromboembolism in infants and children. Recombinant tissue plasminogen activator. Drug Facts and Comparisons. Kennedy LA, Drummond WH, Knight ME, et al.