Search results for "Thrombolysi"
showing 10 items of 120 documents
Reperfusion Treatment in an Acute Myocardial Infarction in Patients Older Than 75 Years. Do We Need a Randomized Controlled Trial?
2005
Fibrinolytic therapy in ST-segment elevation acute myocardial infarction (AMI) constitutes one of the most important advances in cardiology in the last 25 years and has influenced the management and evolution of patients as much as the first coronary care units did. The most important limitations of fibrinolytics are the presence of absolute or relative contraindications to their administration in ≤25% of patients, their limited capacity to restore adequate coronary flow and the risk of inducing cerebral hemorrhage. They are at their most efficient in the first 2 hours’ evolution of AMI but lose their efficacy thereafter. 1 Consequently, treatment must be initiated as early as possible and …
Endovascular thrombectomy with the AngioJet System for the treatment of intermediate-risk acute pulmonary embolism: a case report of two patients
2016
Acute pulmonary embolism (PE) is one of the leading causes of death and ranks third, after myocardial infarction and cerebral stroke, among fatal hospital-related cardiovascular events [1–3]. Mortality associated with PE can be lowered by early treatments aimed at restoring patency of occluded pulmonary arteries (PAs). Although systemic thrombolysis remains the recommended management of PE [4], recent advances in endovascular techniques, especially of rheolytic thrombectomy, suggest that the endovascular approach can represent an alternative therapeutic strategy [5–9]. Here we describe endovascular treatment of two patients with acute PE. We used the AngioJet (Boston Scientific, Natick, MA,…
Therapie thrombembolischer Verschlüsse der Unterschenkelarterien: Klinische Erfahrungen mit dem Angiojet®-Thrombektomiekatheter
1999
UNLABELLED To investigate the clinical impact of a new hydrodynamic thrombectomy catheter in thromboembolic occlusion of tibial arteries. METHOD 10 patients with thromboembolic occlusion of all tibial arteries were treated with the Angiojet thrombectomy device in order to reestablish blood flow. Depending on angiographic and clinical results of thrombectomy, additional thrombolysis, PTA, recanalization, or surgical bypass grafting was performed. RESULTS Antegrade blood flow in at least one tibial artery was reestablished in 6 cases with the thrombectomy device. However, additional treatment modalities were used in order to improve the outcome and to resolve adherent thrombi or to treat vess…
Acute myocardial infarction occurring in versus out of the hospital: patient characteristics and clinical outcome
2000
OBJECTIVES We describe the baseline characteristics and clinical course of patients who had an acute myocardial infarction (AMI) during their hospital stay. BACKGROUND In comparison with patients who had an AMI outside of the hospital (prehospital AMI), the data on patients who had an AMI in the hospital are poorly described. METHODS Patients with an in-hospital AMI were prospectively registered in the Southwest German Maximal Individual TheRapy in Acute myocardial infarction (MITRA) study and compared with patients with prehospital AMI. RESULTS Of 5,888 patients with AMI, 403 patients (6.8%) had an in-hospital AMI. These patients were older, more often male and sicker as compared with the …
Reinfarction Related to PTCA-Induced Coronary Embolism after Successful Thrombolytic Therapy
1989
Coronary embolism originating from residual thrombotic material is one of the complications arising during acute percutaneous transluminal coronary angioplasty (PTCA) in acute myocardial infarction. This case report describes a symptomatic embolization of the right posterolateral and right posterior descending branch during success-ful PTCA of a subtotal stenosis of the midright coronary artery after acute inferior myocardial infarction. Typical ECG signs of reinfarction were recorded. We succeeded in recanalizing these branches by superselective thrombolysis and angioplasty.
Echocardiography in myocardial infarction
1986
This paper discusses the usefulness of echocardiography in thrombolysis, its diagnostic value and drawbacks for therapy and the possibilities for follow-up studies. The diagnostic value is seen in the possibility of localizing and defining the extent of myocardial infarction, not only of the left but also of the right ventricle, and recognizing the complications of myocardial infarction as soon as possible 1, 2, 4.
Indications for early PTCA after thrombolysis
1986
There are several ways to reopen an acutely occluded coronary artery. Thrombolysis can be achieved with various methods (1, 5, 7, 10). After thrombolysis we find that the residual thrombus can sometimes be seen, but in most cases, a more or less high grade coronary stenosis remains (2). It is also a question of whether it is always optimal to reopen the vessel, because if the vessel remains occluded, another occlusion cannot occur. With this situation one faces the possibility that the patient will suffer another infarction, and that the vessel will occlude again (4).
0197: Angiographically visible distal embolization is not linked with culprit lesion but with clinical characteristics
2016
Despite the recent improvements in percutaneous coronary intervention (PCI), angiographically visible distal embolization (AVDE) complicates 6 to 18% of ST elevation myocardial infarction (STEMI) treated with PCI, and is associated with poor clinical outcomes. Culprit lesion characteristics have been proved to be the main predictive factor of AVDE. But data regarding clinical characteristics predicting AVDE are lacking. We aimed to identify predictors of AVDE complicating PCI in STEMI management. 769 consecutive patients admitted for STEMI who underwent PCI were included. Clinical, angiographic and therapeutics characteristics were assessed for each patien. AVDE was defined as an abrupt ves…
Clinical Syndromes, Pathogenesis, and Differential Diagnosis
1991
The temporal sequence of signs and symptoms in patients with cerebral ischemia provides important information for the analysis of underlying pathophysiologic mechanisms and in the search for a major hemodynamic or embolic cause. The signs reported and symptoms assessed are useful for localization of the ischemic region of the brain and identification of the affected vascular territories. Even in the case of a typical clinical picture the clinical findings alone are often insufficient for unequivocal anatomic and pathologic identification, however important they may be in the choice of diagnostic and therapeutic measures. In the first few hours after cerebral ischemia, determining the progno…
In-hospital outcomes of catheter-directed thrombolysis in patients with pulmonary embolism
2020
Abstract Background and purpose Catheter-directed treatment of acute pulmonary embolism (PE) is technically advancing. Recent guidelines acknowledge this treatment option for patients with overt or imminent haemodynamic decompensation, particularly when systemic thrombolysis is contraindicated or has failed. We investigated baseline characteristics and in-hospital outcomes of patients with PE who underwent catheter-directed thrombolysis (CDT) in the German nationwide inpatient cohort. Methods Data from hospitalizations with PE between 2005 and 2016 were collected by the Federal Office of Statistics (Statistisches Bundesamt) in Germany and included in this analysis. Patients with PE who unde…