TPA (Alteplase) for Femoral Pulse Loss after Cardiac Catheterization

Am J Cardiol 2003;91:908-910

Bolus 0.1 mg/kg over 5-10 min, followed by 0.5 mg/kg/hr x 2 hrs.
Resume Heparin at 17 Units/kg/hr for at least 4 hrs after Alteplase infusion completes.
(Heparin infusion may be continued without interruption during Alteplase infusion).

If there is no improvement at about 4-6 hrs from first dose of Alteplase, repeat dose may be given. Important to give heparin infusion for at least 4-6 hrs after completion of any dose of Alteplase. (To deal with increased thrombotic tendency after Alteplase therapy.

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