This study investigates whether alteplase can help to improve pleural fluid drainage and dyspnea (breathlessness) in patients with non-draining malignant pleural effusion. Alteplase helps dissolve blood clots and is used to treat heart attacks, strokes, and clots in the lungs. Alteplase may help to control symptoms of breathlessness.
Referral to pulmonary services for inability to drain fully via IPC
Presence of a symptomatic septated pleural effusion
Chest radiograph: effusion filling >= 1/3 of the hemithorax, or
Computed tomography (CT)-scan: AP depth of the effusion >= 1/3 of the AP dimension on the axial image superior to the hemidiaphragm, including atelectatic lung surrounded by effusion, or
Inability to provide informed consent
Uncorrectable coagulopathy based on criteria followed by cardiopulmonary center for procedures.
Active bleeding
Known allergic reaction to thrombolytics
Single group
Alteplase
Biological/VaccineInstilled into IPC
Placebo Administration
DrugInstilled into IPC
Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events
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