Clinical experience with alteplase in the management of intracardiac and major cardiac vessels thrombosis in pediatrics: a case series.


BACKGROUND AND OBJECTIVES:Experience with alteplase in pediatric patients is limited and recommendations are extrapolated from adult data. Comprehensive guidelines on the management of thromboembolic events in this group are lacking. We assessed the efficacy and safety of alteplase (recombinant tissue plasminogen activator) in the management of intracardiac and major cardiac vessel thrombosis in pediatric patients. METHODS:All pediatric patients, 14 years of age and younger, with intracardiac or major cardiac vessel thrombus who were treated with alteplase from 1997 to 2004 at our tertiary care institute were identified through the pharmacy database. Patient data were retrospectively evaluated for the efficacy and safety of altepase. RESULTS:Five cases were eligible out of nineteen who received alteplase. Patient ages ranged from 40 days to 13 years. The initial dose of alteplase ranged from 0.3 to 0.6 mg/kg followed by a continuous infusion in three patients with a dosage range between 0.05 and 0.5 mg/kg/hr, while intermittent infusion was used in the other two patients. The duration of therapy ranged from 2 to 4 days. By the end of the treatment, two patients had complete resolution of thrombus and one had partial resolution. Two patients failed to respond and had "old" thrombus. Major bleeding events were reported in three patients. The rest had minor bleeding events. CONCLUSION:Alteplase may effectively dissolve intracardiac thrombi, particularly when freshly formed. Continuous infusion for a long duration appears to be associated with an increased risk of major bleeding. Optimal dose and duration of infusion are still unknown.


Ann Saudi Med


Annals of Saudi medicine


Al-Jazairi AS,Al-Gain RA,Bulbul ZR,Cherfan AJ




Has Abstract


2010-05-01 00:00:00














  • Gender differences in the clinical characteristics of Saudi heart failure patients with subsequent stroke.

    abstract:BACKGROUND AND OBJECTIVES:Studies about stroke in Saudi Arabia are limited. This retrospective study aims to determine the clinical characteristics of Saudi patients with heart failure (HF) with and without subsequent stroke, and also to find out whether gender differences exist in the presentation of HF patients who h...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Alqahtani M,AlKhtaami A,AlGobain M,Aljohani N,Bin SA,AlShalati F,Alanazi T

    更新日期:2013-07-01 00:00:00

  • Cerebral palsy: comprehensive review and update.

    abstract::Cerebral palsy (CP) is a common pediatric disorder occurring in about 2 to 2.5 per 1000 live births. It is a chronic motor disorder resulting from a non-progressive (static) insult to the developing brain. CP is the clinical presentation of a wide variety of cerebral cortical or sub-cortical insults occurring during t...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章,评审


    authors: Jan MM

    更新日期:2006-03-01 00:00:00

  • Profile of mycosis fungoides in 43 Saudi patients.

    abstract:BACKGROUND AND OBJECTIVES:Mycosis fungoides (MF) is a rare disease; and to our knowledge, there are no reports on its profile in Arabs. The objective of this study was to preliminarily analyze the clinical characteristics of MF patients seen in our institution. DESIGN AND SETTING:Retrospective review of 140 patients w...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: AlGhamdi KM,Arafah MM,Al-Mubarak LA,Khachemoune A,Al-Saif FM

    更新日期:2012-05-01 00:00:00

  • Neural tube defects in Southwestern region of Saudi Arabia.

    abstract::During December 1987 to December 1990 the incidence of neural tube defects in the Asir region located in southwestern Saudi Arabia was 0.82/1000. These results were drawn from a survey conducted of all cases of neural tube defects referred to the main hospital at Abha City (Asir Central Hospital) (ACH). Anencephaly wa...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: El-Awad Mel-H,Sivasankaran S

    更新日期:1992-09-01 00:00:00

  • Implementation of total laboratory automation at a tertiary care hospital in Saudi Arabia: effect on turnaround time and cost efficiency.

    abstract:BACKGROUND:Total laboratory automation (TLA) is a relatively new way of improving the management of high volume clinical laboratories. TLA may reduce staff, reduce operating costs, decrease testing time and provide enhanced process control. OBJECTIVES:Establish a cost efficient TLA that is less labor intensive, improv...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Ellison TL,Alharbi M,Alkaf M,Elimam S,Alfaries M,Nounou RA,Nasr R,Owaidah T

    更新日期:2018-09-01 00:00:00

  • Role of endoscopic retrograde cholangiopancreatography before and after laparoscopic cholecystectomy.

    abstract:BACKGROUND:While the role of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) in the diagnosis and management of choledocholithiasis is well established, this study evaluates the usefulness of ERCP and EST in patients with symptomatic cholecystolithiasis and suspected choledocho...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Sbeih F,Aljohani M,Altraif I,Khan H

    更新日期:1998-03-01 00:00:00

  • Emerging global epidemic of obesity: the renal perspective.

    abstract::Obesity, as a core component of the metabolic syndrome, is among the top ten global health risks classified by the World Health Organization (WHO) as being strongly associated with the development and progression of chronic renal disease--a widely prevalent but often silent condition. Obesity carries elevated risks of...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章,评审


    authors: Saxena AK

    更新日期:2006-07-01 00:00:00

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    abstract:BACKGROUND AND OBJECTIVES:Infantile colic is a common problem among young infants. Cow's milk allergy has been suggested as one of the causes. We aimed to investigate the value of the cow's milk skin test for the diagnosis of cow's milk allergy in exclusively breast-fed infants with infantile colic. METHODS:Exclusivel...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章,随机对照试验


    authors: Moravej H,Imanieh MH,Kashef S,Handjani F,Eghterdari F

    更新日期:2010-11-01 00:00:00

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Al Rashed RS

    更新日期:1997-03-01 00:00:00

  • Minimally invasive neurosurgery using CRW-3 stereotaxy.

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Sharma RR,Davis CH,Lynch PG,Keogh AJ

    更新日期:1994-11-01 00:00:00

  • Characteristics of Saudi patients with congestive heart failure and adherence to management guidelines in a tertiary hospital in Riyadh.

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Alqahtani M,Alanazi T,Binsalih S,Aljohani N,Alshammari M,Ashagag A,Abdullah M,Buabbas S,Abdulbaqi M

    更新日期:2012-11-01 00:00:00

  • Designing an autoverification system in Zagazig University Hospitals Laboratories: preliminary evaluation on thyroid function profile.

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Sediq AM,Abdel-Azeez AG

    更新日期:2014-09-01 00:00:00

  • Aberrant internal carotid artery in the middle ear.

    abstract::An aberrant internal carotid artery (ICA) in the middle ear space can present in 1% of the population. The clinical diagnosis can be difficult as most patients with this anomaly are either asymptomatic or have nonspecific clinical symptoms and signs. Moreover the diagnosis can easily be missed and only discov.ered whe...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Alharethy S

    更新日期:2013-03-01 00:00:00

  • Geographical distribution of congenital heart defects in Saudi Arabia.

    abstract:BACKGROUND:Congenital heart defects (CHD), which are caused by abnormalities early in fetal life, encompass over 50 diagnoses. Since the detailed etiology is unknown, the geographical distribution of defects might suggest likely risk factors. METHODS:The geographical distribution of 5 865 Saudi Arabian nationals with ...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Greer W,Sandridge AL,Al-Menieir M,Al Rowais A

    更新日期:2005-01-01 00:00:00

  • Evaluation of anti-ds DNA antibody measurement by using commercial kits for use in a clinical laboratory.

    abstract::Three hundred and seventy-six consecutive antinuclear antibody-positive sera were tested for anti-ds DNA antibody by using three commercial kits which use 125 I recombinant DNA (radioimmunoassay), highly purified calf thymus DNA (enzyme linked immunosorbent assay) and Crithidia lucilliae (immunofluorescence assay) as ...

    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Sheth KV,Alkaff MA,Bahabri SA,El Ramahi KM,Al-Sedairy S,Al-Dalaan AA

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  • Survival and metastasis in muscle-invasive bladder cancer patients who present with indeterminate pulmonary nodules before treatment.

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


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    authors: Cavusoglu C,Durmaz R,Bilgic A,Gunal S

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  • Demographic and clinical features of diabetes mellitus in 1095 Yemeni patients.

    abstract::The ever-increasing incidence of diabetes mellitus is a cause for growing public health concern in both developed and developing countries. In this study, we aim to explore the special demographic and clinical features of diabetes, as seen in a large sample of Yemeni patients, and to compare these features with those ...

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    pub_type: 杂志文章


    authors: Gunaid AA,El Khally FM,Hassan NA,Mukhtar el D

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  • Sonographic fetal weight estimation using femoral length: Honarvar equation.

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    journal_title:Annals of Saudi medicine

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    journal_title:Annals of Saudi medicine

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Shehab A,Al-Habib K,Hersi A,Al-Faleh H,Alsheikh-Ali A,Almahmeed W,Suleiman KJ,Al-Motarreb A,Suwaidy JA,Asaad N,AlSaid S,Hashim M,Amin H

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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


    authors: Khandekar S,Noeman SA,Muralidhar K,Gadallah M,Al-Sawaf KS

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    pub_type: 杂志文章


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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


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    pub_type: 杂志文章


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    journal_title:Annals of Saudi medicine

    pub_type: 杂志文章


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    更新日期:2006-01-01 00:00:00