Thrombolysis

Does thrombolysis for pulmonary embolism reduce the risk of chronic complications?

Original Articles, Volume 20, Issue 1, Pages 1-88 (2021)

We assessed the efficacy of thrombolysis in avoiding long-term complications.

Notes of patients thrombolysed for PE in the 2-year period were reviewed. The initial CTPA and echocardiogram results before thrombolysis were compared to the results of follow up imaging repeated after 6 months.

Twenty-two patients were thrombolysed for PE. 14 patients had sub-massive PE and 8 patients had massive PE. The right ventricle (RV) was dilated on pre-thrombolysis echocardiogram in 16 patients.

On follow up echocardiography all patients with massive PE (6 studies) had a normal RV size, with pulmonary artery pressures (PAP) of 29mmHg. Follow up echocardiography of patients with submassive PE (13 studies) showed 11 patients with a normal RV, with PAP of 28 mmHg.

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Management of Acute Ischaemic Stroke in the Acute Medical Unit

Clinical Reviews, Volume 9, Issue 3, Pages 97 - 148 (2010)

Abstract

Ischaemic stroke is a major cause of death and disability which costs the NHS £2.8 billion/year. Acute stroke care is developing rapidly in line with an increasing evidence base. Intravenous thrombolysis is now recommended by NICE. For this guidance to be effectively implemented stroke must be viewed as a medical emergency by both the public and professionals. Emergency medical services must work in partnership with stroke services to establish systems and protocols which offer high quality acute stroke care. This provides challenges, both in systems design and delivery of clinical care.

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A Successful Case of Repeat Thrombolysis in Acute Prosthetic Valve Thrombosis

Case Reports, Volume 9, Issue 2, Pages 53 - 96 (2010)

Abstract

Acute heart failure is an important presentation in the Acute Medical Unit. We describe a case of successful repeat thrombolysis in an elderly woman presenting as an emergency with severe pulmonary oedema, due to acute prosthetic mitral valve thrombosis. The diagnostic imaging and therapeutic modalities available are also described.This case highlights the need for acute physicians to consider prosthetic valve thrombosis in the differential for patients with metallic heart valves who present with acute heart failure or cardiogenic shock.

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Advances in Deep Vein Thrombosis Management with Thrombolysis

Clinical Reviews, Volume 8, Issue 2, Pages 51 - 94 (2009)

Abstract

Lower extremity deep vein thrombosis (DVT) is a common disease associated with serious short term and long term complications. Its conventional treatment has been anticoagulation. Thrombolytic treatment has been used for DVT for over 40 years. More recently catheter directed thrombolysis has taken over systemic thrombolysis. This technique is useful to prevent post thrombotic syndrome (PTS) after DVT.

In this review article we present a case of DVT thrombolysis in our hospital, look at the pathophysiology of PTS, the mechanism of thrombolysis and the current status of thrombolysis in DVT.

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The Management of ST-segment Elevation Myocardial Infarction

Clinical Reviews, Volume 3, Issue 1, Pages 1 - 44 (2004)

Abstract

The definition and management of ST-segment elevation myocardial infarction (STEMI) has changed considerably over the past few years. This article has been written as an update to encompass the National Service Framework (NSF) for coronary heart disease (published in England in March 2000 1 and in Wales in July 20012), the Scottish Intercollegiate Guidelines Network 3 and the recent Task Force Report by the European Society of Cardiology (January 2003).4

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