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Anticoagulation as Adjunctive Treatment and One-Hour Alteplase Infusion

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Thrombolysis in Pulmonary Embolism

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Abstract

Adjunctive treatment in the setting of cardiovascular thrombolysis is the cornerstone to avoid recurrence establishing a bridge to starting oral anticoagulation with oral vitamin-K antagonists or activated factors anticoagulants. In addition, bleeding complications in the first 20- or 48-h could be related with the adjunctive treatment. So, it is important that physicians linked with PE patients care choose the best option. In this chapter the position of European and North American societies will be analyzed. Also, experiences with fondaparinux and unfractionated heparin regimen use in ST-myocardial infarction patients will be analyzed. Additionally, based on our previous successful experience with ST-elevation myocardial infarction regimen with a first generation fibrinolytic, we decided to use recombinant human tissue-type plasminogen activator in PE patients with efficacy and safety, as has been used in myocardial infarction patients. Although we did not have head-to head studies, less residual thrombosis with recombinant human tissue-type plasminogen activator compared with a first generation fibrinolytic was observed.

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Authors and Affiliations

  1. Instituto de Cardiologia y Medicina Vascular, TEC Salud, San Pedro Garza Garcia, Nuevo León, Mexico

    Carlos Jerjes-Sánchez M.D., F.C.C.P., F.A.C.C. (Sistema Nacional de Investigadores, Nivel II – Clinical Research Director)

  2. Escuela de Medicina, Tecnológico de Monterrey, San Pedro Garza Garcia, Nuevo León, Mexico

    Carlos Jerjes-Sánchez M.D., F.C.C.P., F.A.C.C. (Sistema Nacional de Investigadores, Nivel II – Clinical Research Director)

  3. Unidad de Investigacion Clinica en Medicina SC, Monterrey, Nuevo León, Mexico

    Carlos Jerjes-Sánchez M.D., F.C.C.P., F.A.C.C. (Sistema Nacional de Investigadores, Nivel II – Clinical Research Director)

  4. Department of Emergency Room, Hospital de Cardiologia No. 34, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico

    Anabel Garcia-Sosa M.D.

Authors
  1. Carlos Jerjes-Sánchez M.D., F.C.C.P., F.A.C.C.
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  2. Anabel Garcia-Sosa M.D.
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Correspondence to Carlos Jerjes-Sánchez M.D., F.C.C.P., F.A.C.C. .

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Jerjes-Sánchez, C., Garcia-Sosa, A. (2015). Anticoagulation as Adjunctive Treatment and One-Hour Alteplase Infusion. In: Thrombolysis in Pulmonary Embolism. Springer, Cham. https://doi.org/10.1007/978-3-319-19707-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-19707-4_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19706-7

  • Online ISBN: 978-3-319-19707-4

  • eBook Packages: MedicineMedicine (R0)

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