Haque, "Does thrombolysis
have a place in the cardiopulmonary resuscitation of patients with acute pulmonary embolism?
Currently options of treatment include surgical treatment, thrombolysis
, anticoagulation and percutaneous aspiration.
With the written consent of the family and in the absence of contraindications, intravenous thrombolysis
at a dose of 72 mg (7.2 mg intravenous bolus, then 62.8 mg via intravenous perfusion, over 1 hour) was initiated, with improvement of the motor deficit, facial asymmetry and speech and language disorders at the end of perfusion, symptoms corresponding to a NIHSS score of 5 points (of the 16 points before iv.
Furthermore, it has been shown that it is needed to treat 4.5 patients with AIS by intravenous thrombolysis
in order to have one patient fully recovered (number needed to treat - NNT) if the drug is applied within the first 90 minutes after symptom onset.
Administering thrombolytic agents systemicallyis often associated with difficulties that include long infusion times and a high incidence of partial thrombolysis
. An alternative to systemic agent administration is the use of catheter-directed thrombolytic therapy.
It should be considered particularly for cases in which thrombolysis
is contraindicated or if thrombolysis
is ineffective or in patients with patent foramen ovale with potential for systemic embolization.
While the risk of hemorrhagic complications including intracerebral hemorrhage (ICH) remains to be a potentially devastating complication following the use of thrombolysis
, there were no reported cases of ICH within the thrombolysis
arm in this systematic review by Khatri et al.
Catheter-directed pharmacological thrombolysis
restores vein patency in 64 to 84% cases, with improved patency rates associated with earlier initiation of therapy .
To quantify thrombogenesis and thrombolysis
under flow conditions, the T-TAS assay was performed as previously described .
Systemic anticoagulation and thrombolysis
treatments were required after surgical treatment.
The number of patients receiving clot-busting drugs, known as thrombolysis
, has continued to increase from 358 in 2012-13 to 501 in 2014-15.
The therapeutic options for PTE management include systemic anticoagulation, systemic thrombolysis
, catheter-directed thrombolysis
(CDT) and surgical thrombectomy.