Q: What are the evidence-based recommendations for nursing management of a patient with an EKOS catheter?

A: Sara Knippa, MS, RN, ACCNS-AG, CCRN, PCCN, and Shannon Vernon, BSN, RN, CCRN, reply:

Catheter-directed thrombolysis (CDT) is a targeted alternative to systemic thrombolysis. It can be used for patients experiencing thrombotic problems such as deep vein thrombosis, pulmonary embolism, and peripheral arterial occlusion. In CDT, an infusion catheter is inserted into the artery or vein through a sheath and guided to the site of the thrombus. A thrombolytic agent, often alteplase, is continually infused through the catheter directly to the clot for a particular amount of time.1 

Therapy using an EKOS catheter, as part of the EkoSonic Endovascular System (Boston Scientific), takes CDT a step further by adding intravessel ultrasound. The EkoSonic Endovascular System (EKOS) consists of a specialized catheter (see Figure) and a control unit. The catheter delivers small...

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