When should thrombolytic therapy not be used?

When should thrombolytic therapy not be used?

Absolute Contraindications for Thrombolytic Treatment

• Recent intracranial hemorrhage (ICH)
• Structural cerebral vascular lesion.
• Intracranial neoplasm.
• Ischemic stroke within three months.
• Possible aortic dissection.
• Active bleeding or bleeding diathesis (excluding menses)

When is thrombolytic therapy indicated?

Thrombolytic therapy is indicated in patients with evidence of ST-segment elevation MI (STEMI) or presumably new left bundle-branch block (LBBB) presenting within 12 hours of the onset of symptoms if there are no contraindications to fibrinolysis.

Is thrombolytic therapy effective for pulmonary embolism?

Thrombolytic therapy is usually reserved for patients with clinically serious or massive pulmonary embolism (PE). Evidence suggests that thrombolytic agents may dissolve blood clots more rapidly than heparin and may reduce the death rate associated with PE.

When is TPA indicated PE?

Indications for thrombolysis are not well defined and are thus controversial. The only current absolute indication is massive pulmonary embolism with hypotension. Other potential indications include right heart dysfunction, recurrent pulmonary embolism and the prevention of pulmonary hypertension.

What is successful thrombolysis?

Successful clinical reperfusion (SCR) was defined as the presence of at least two of the following criteria at 2 hours after thrombolytic treatment: (1) significant relief of pain (a 5-point reduction on a 1 to 10 subjective scale), (2) > or =50% reduction of sum of ST segment elevation, and (3) abrupt initial increase …

What drug is used for thrombolysis?

The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same thing. Ideally, you should receive thrombolytic medicines within the first 30 minutes after arriving at the hospital for treatment. A blood clot can block the arteries to the heart.

What makes a PE massive?

Massive PE is characterized by systemic hypotension (defined as a systolic arterial pressure < 90 mm Hg or a drop in systolic arterial pressure of at least 40 mm Hg for at least 15 min which is not caused by new onset arrhythmias) or shock (manifested by evidence of tissue hypoperfusion and hypoxia, including an …

What is a massive PE?

Massive (or high-risk) PE is a term used to designate patients with sustained hypotension (systolic blood pressure <90 mmHg for at least 15 minutes or requiring inotropic support, not due to a cause other than PE), pulselessness, or persistent profound bradycardia.