Catheter-Directed Bivalirudin for Local Anticoagulation and Clot Dissolution in Children Requiring Mechanical Circulatory Support

Bivalirudin is a direct thrombin inhibitor that inhibits both circulating thrombin and fibrin-bound thrombin, giving it the ability to not only prevent thrombus extension, but also more directly facilitate clot resolution than heparin. Although still not yet the standard of care, bivalirudin has become more frequently used for anticoagulation in patients on mechanical circulatory support. In patients who develop large or critically localized thrombosis, requiring catheter-directed therapy, alteplase remains the drug of choice. Here we describe three cases of children, all of whom were on mechanical circulatory support, who required catheter-directed thrombolysis. In each case, direct bivalirudin delivery through a lysis catheter was associated with rapid resolution of thrombosis. Although study of more patients is needed to truly assess safety and efficacy, this series demonstrates that bivalirudin may be an effective drug for thrombolysis and should be considered in patients who have experienced bleeding or other complications from catheter-directed alteplase infusion.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Three pediatric case series describing catheter-directed delivery of bivalirudin for local thrombolysis in children on mechanical circulatory support, showing rapid clot resolution as an alternative to alteplase.

Leech-derived molecules this paper discusses, each with a full profile in the ASH compound registry:

Узнайте, как это исследование связано с клинической практикой

More peer-reviewed studies in Разработка лекарственных препаратов.

• Novel Leech Antimicrobial Peptides — Hirunipins — Kumar et al. (2025)
• Medicinal Leech Genome Assembly — Anticoagulant Gene Catalog — Kvist et al. (2020)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Hirudotherapy in Medicine and Dentistry — Jha K et al. (2015)
• Medicinal leech therapy (hirudotherapy): a brief overview — Singh A (2010)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Investigation of oxidant-antioxidant status in patients treated with hirudotherapy: an experimental study — Sarikan I, Savas H (2024)
• Leech therapeutic applications — Abdualkader A et al. (2013)
• Non-Occlusive Mesenteric Ischemia Due to Hirudotherapy: A Case Report — Akalın Ç, Ekmen N (2020)
• Leech therapy: a history — Hyson J (2005)

Browse all ASH-analysed research →