Thrombolytic therapy for noncoronary diseases.
Thrombolytic therapy has been used fairly extensively in the management of acute proximal deep-vein thrombophlebitis of the extremities, acute pulmonary embolism, and acute peripheral arterial thrombosis and embolism in addition to acute thrombotic coronary events. In the presence of acceptable indications and a favorable benefit to risk ratio, this form of therapy, when successful, has served as a useful adjunct in the management of these disorders. In deep-vein thrombophlebitis, lysis of the thrombus before permanent pathological changes (eg, organization, scarring) have occurred can prevent venous valvular dysfunction and postural venous hypertension and its complications, especially the postphlebitic syndrome. In the more severe forms of acute pulmonary embolism, thrombolytic therapy, when applied early after symptom onset, decreases morbidity and is likely to prevent a chronic increase in pulmonary vascular resistance and persistent pulmonary hypertension. In peripheral arterial thrombo-occlusive events, early restoration of flow through thrombolysis has been shown to limit ischemic damage and serve as a useful supplement to angioplasty or surgery. Thrombolytic therapy has been used less extensively in acute strokes. Here the danger of reperfusion causing bleeding into a softened area of brain undergoing infarction has slowed its evaluation for this disorder; its application to stroke remains experimental.
Sherry
S
S
School of Medicine, Temple University, Philadelphia, Pennsylvania 19140-9999.
D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000188:drug therapy; D002544:Cerebral Infarction / Q000188:drug therapy; D000075202:Contraindications; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy; D013923:Thromboembolism / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D013924:Thrombophlebitis / Q000188:drug therapy