1995
DOI: 10.1016/s0009-9260(05)83212-x
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Accelerated thrombolysis with high dose bolus t-PA extends the role of peripheral thrombolysis but may increase the risks

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Cited by 22 publications
(17 citation statements)
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“…Another hypothesis is that TPA, with its higher fibrin selectivity, may lyse hemostatic thrombi more efficiently, leading to potentially more bleeding from sites of vascular injury. Other authors, [16][17][18][19] however, have reported only 7 to 13% incidence of minor hematomas when using a low dose of TPA.…”
Section: Discussionmentioning
confidence: 94%
“…Another hypothesis is that TPA, with its higher fibrin selectivity, may lyse hemostatic thrombi more efficiently, leading to potentially more bleeding from sites of vascular injury. Other authors, [16][17][18][19] however, have reported only 7 to 13% incidence of minor hematomas when using a low dose of TPA.…”
Section: Discussionmentioning
confidence: 94%
“…A higher dose of rtPA can accelerate the thrombolysis and achieve faster restoration of blood flow, a potential advantage to patients with acute ischaemia14,25,26. Faster thrombolysis with a higher dose of rtPA is counterbalanced by a higher rate of bleeding complications16,25; the risk of bleeding must be weighed against the risk of surgery or amputation for each patient27.…”
Section: Discussionmentioning
confidence: 99%
“…19 Additionally, accelerated thrombolysis with a saturating high dose of rtPA followed by a slower continuous infusion of the lytic agent appears to predict the outcome of thrombolysis; if lysis occurs during the bolus phase, the so-called ''trial of lysis,'' the entire procedure is likely to succeed. 20 If there is no response to the initial boluses, continued infusions are justified only in limbs able to tolerate ischemia for Ͼ4 hours. Finally, accelerated thrombolysis with initial high-dose boluses is very convenient because the patient can be transferred to a nearby area to continue the infusion, so the angiography table becomes available for another procedure.…”
Section: Discussionmentioning
confidence: 99%