Hemorrhagic stroke as a rare complication of opening the permanent dialysis catheter by Reteplase: A case report study

Introduction and importance: Thrombosis of permanent hemodialysis catheters is one of the most important problems in hemodialysis centers. Drug methods such as heparin, aspirin and warfarin along with urokinase are used to keep these catheters open. Case presentation: The present case report is of a 52-year-old Kurdish patient with a 7-year history of type 2 diabetes and hypertension leading to end-stage renal disease (ESRD). The patient has been undergoing hemo-dialysis for two months with two 3-h sessions per week. After several dialysis sessions, the patient is referred to Imam Khomeini Hospital in Urmia to open the catheter due to dysfunction. Because of catheter dysfunction, Reteplase (Retavase; Centocor, Malvern, PA) was administered at a dose of 3 U/lm (total dose 6 U). After administration of reteplase, the patient experienced sudden onset of headache and arterial hypertension. A computed tomography scan (CT) was immediately performed and revealed hemorrhagic stroke. Unfortunately, due to the extensive hemorrhagic stroke, the patient died one day later.Clinical discussion: Retavase (reteplase) is a thrombolytic drug used to dissolve blood clots. Reteplase increases your risk for bleeding, which can be severe or life-threatening.Conclusion: Thrombolysis with tissue plasminogen activator has been shown to be useful in some conditions. However, reteplase has a narrow therapeutic window and serious side effects, such as an increased risk of bleeding.