When central venous access devices are inserted into the bloodstream, their surface becomes coated with fibrin and other circulating plasma proteins. In most short term situations, this fibrin coating does not lead to catheter dysfunction. Overtime however, fibrin along with platelets and red blood cells, can form a clot within the catheter lumen or around it's tip. Such clots can make it difficult or impossible to inject or withdrawal fluids. In fact, they are the most common cause of catheter dysfunction. Alteplase is an effective, safe, and easy way to dissolve clots within central venous access devices and restore catheter function as assessed by the ability to withdrawal blood. Unlike Heparin, Alteplase is a fibrinolytic specifically-designed to target and bind to fibrin within the clot. It does so by binding to plasminogen, converting it to plasmin, which in turn breaks apart the strands of fibrin within a clot, initiating clot lysis. The clot is then dissolved and any residual debris can be aspirated from the catheter, effectively restoring central venous access.
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