TPA (Altaplase)

TPA or Alteplase is medicine used to break down blood clots.

If your child has a central line such as a Hickman or Broviac, a PICC line, a dialysis catheter or a port, they may eventually need a line treatment with a product called TPA. Normally, blood does not tend to clot in a central line. However, sometimes blood can clot on the inside of the line enough to make it hard or impossible to give medicines or draw blood.

TPA is known as a “clot buster”. TPA will immediately begin to break up the clot that is blocking the line. The medicine does not go into your child. Instead, TPA simply sits in the line to work on breaking up the clot. TPA stays in for 1 to 2 hours for maximum effect. Its action can be compared to dish soap breaking up the grease on dishes. After it has sat in the line for the prescribed time, the medicine is taken out and the line will be checked to see if it worked.

Sometimes the central line may need a second or third dose. If these steps do not work, we will talk with your provider to make a new plan.

Any nurse, doctor, or advanced care provider (PA, ARNP) who has been certified to give TPA can give the medicine.

As with any medicine, there are risks. Bleeding can happen, but is minimal because we only give a small amount intended to stay in the child’s central line. If TPA goes past the line and into your child, the risks are still very low because only a small dose is used. Contact your nurse or provider if you see any signs or symptoms of bleeding.