Standard of Care

Cathflo® Activase® (alteplase) is the standard of care for treatment of thrombotically occluded catheters

Use Cathflo as approved by the FDA

Cathflo is the only FDA-approved thrombolytic agent 1-8,23:
  • Used for the restoration of function to central venous access devices (CVADs) as assessed by the ability to withdraw blood 2
  • Recommended by clinical practice standards, including 1,3-7:
    • Infusion Nurses Society (INS) 
    • Association for Vascular Access (AVA) 
    • American Association of Critical Care Nurses (AACN)
    • Oncology Nursing Society (ONS)
  • That is available in a single-use 2 mg vial; it is not recommended that it be compounded, frozen or thawed8
  • With an efficacy and safety profile demonstrated in pediatric and adult patients

Key societies that support using Cathflo Activase (alteplase) to restore function to CVADs:


Infusion Nurses Society

  • The instillation of 2 mg of alteplase (Cathflo Activase) is effective in restoring catheter patency in patients 1
  • Instillation of alteplase (Cathflo Activase) based on manufacturers' directions for use is recommended in current guidelines. There is limited research available to support the efficacy of thrombolytic drugs for alternative dosing 1

Class 1; Level of evidence A. INS Infusion Therapy Standards of Practice, 2021, page S151, standard 49, practice F


CDC Guideline for Isolation Precautions, 2007, page 83, section IV.H.5


Association for Vascular Access

  • Alteplase 2 mg (Cathflo Activase) is the only FDA-approved thrombolytic agent for the treatment of dysfunctional CVADs 6

AVA Study Guide, 2011, page 42, section F1-c


American Association of Critical-Care Nurses

"Declotting is done with 2 mg of tPA [alteplase, Cathflo Activase]."
AACN Critical Care Nurse, 2007


Oncology Nursing Society

  • Use 2 mg alteplase (Cathflo Activase) to restore patency and maintain catheter function 3

Practice Standard B (Level 1). ONS Access Device Standards of Practice, 2017, page 10, Section VI, practice standard B

See the Resource Center for other catheter management resources and organizations.

Genentech neither is affiliated with nor endorses the above organizations.

NEXT: Review the efficacy and safety profile of Cathflo >

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The only thrombolytic agent FDA-approved for adult and pediatric patients, Cathflo Activase (alteplase) has the highest level of evidence regarding the treatment of thrombotic occlusions (INS, Class 1, Level of evidence A; ONS Practice Standard, Level 1). 1,3,23