Thrombolytic therapy in cerebrovascular disease.

Thrombolytic Therapy in Cerebrovascular Disease

Arterial thrombosis and thrombus extension involve the overlapping systems of endothelial cell reactivity, platelet function, and coagulation. Thrombotic cerebrovascular occlusions arise secondary to thromboembolism from more proximal sites, e.g., the heart and proximal internal carotid artery, or from in situ thrombosis. Thrombus generation and extension involve thrombin-mediated fibrin format...

Current status of thrombolytic agents in acute cerebrovascular disease.

Thrombolytic Therapy for Arterial Disease

Pearls 1. Patient workup and evaluation is key to a successful intervention while limiting complications. In addition to physical exam and laboratory evaluation, review of prior imaging studies and surgical interventions is important to understanding the etiology of the occlusion and to guide therapy. 2. Use of arterial thrombolysis should be avoided in patients with evidence of irreversible li...

Thrombolytic therapy in peripheral vascular disease.

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Antithrombotic and Thrombolytic Therapy for Valvular Disease

We were pleased to read the article by Whitlock et al 1 in the February 2012 supplement issue of CHEST . They concluded, “In patients with a mechanical mitral valve (both the aortic and mitral position), we suggest [vitamin K antagonist] therapy with a target [international normalized ratio (INR)] of 3.0 (range, 2.5-3.5).” 1 However, we have several concerns about their conclusion. First, thro...