Intraventricular Fibrinolysis in Patients with Intraventricular Hemorrhage (P05.200)

OBJECTIVE: To present our experience using intraventricular fibrinolysis over 12 years. BACKGROUND: Intraventricular fibrinolysis has been shown effective in clearing intraventricular hemorrhage (IVH) in small series of patients. DESIGN/METHODS: Retrospective analysis of prospectively collected data of patients admitted with IVH and treated with rt-PA instillation via intraventricular catheter (IVC) until clearance of the 3 rd and 4th ventricles. The Graeb and LeRoux semiquantitative scales were used to measure the amount of IVH before and after the last dose. RESULTS: 55 patients (mean age 58.6 years, 58.2% male) had the following admission diagnoses: 30 intracerebral and 17 aneurysmal subarachnoid hemorrhage, 4 brain tumors, 1 head trauma, 1 arteriovenous malformation, 1 primary IVH and 1 post IVC placement. rt-PA was administered at a total dose of 5.1±4.7mg (individual doses ranging between 0.5 to 4 mg). The pre-fibrinolysis Graeb and LeRoux scores of 8.1±1.8 and 11.3±2.5,decreased post fibrinolysis to 4.6±1.8 and 5.3±2.6 (p CONCLUSIONS: In our large series, intraventricular fibrinolysis entailed minimal complications. The higher the total dose of rt-PA, the less the blood remaining inside the ventricles and the more ventricular blood removed, the better the outcome. Disclosure: Dr. Varelas and his spouse holds stock and/or stock options in The Medicines Company. Dr. Varelas has received research support from The Medicines Company. Dr. Mays-Wilson has nothing to disclose. Dr. Abdelhak has nothing to disclose. Dr. Spanaki holds stock and/or stock options in The Medicines Company. Dr. Helms has nothing to disclose.