Thrombolytic Therapy in Acute Care: A Comprehensive Overview of Therapeutic Approaches and Clinical Outcomes

Lt Col Cecily PJ; Mamata Nayak; Neetu Kumari Ram; Dr Anugrah Thomas; Monalisha Pal1

1

Publication Date: 2024/08/21

Abstract: Thrombolytic therapy is a vital component in the treatment of acute illnesses such as myocardial infarction, ischemic stroke, and pulmonary embolism. Its purpose is to minimize tissue damage and restore perfusion. With an emphasis on the use of tissue plasminogen activator (tPA) and other drugs, the timing of administration, and the related clinical results, this study thoroughly analyses the therapeutic approaches to thrombolysis. Research shows that by lowering death and morbidity, early administration—ideally, during the first few hours after symptom onset—significantly improves outcomes. Treatment options have increased, especially for patients who are not good candidates for systemic thrombolysis, because to developments in thrombolytic drugs and delivery systems, such as catheter-directed thrombolysis and ultrasound-enhanced thrombolysis. It is important to carefully choose and monitor patients receiving thrombolytic treatment since, despite its advantages, it has some contraindications, including the possibility of haemorrhagic consequences. A customized treatment plan is essential to optimize effectiveness while avoiding side effects, as demonstrated by the outcomes of several clinical trials. In Result it should be noted that research is still being done to determine the best ways to employ thrombolytic treatment to enhance patient outcomes in acute care settings.

Keywords: Thrombolytic Therapy, Acute Care, Tissue Plasminogen Activator, Ischemic Stroke, Acute Myocardial Infarction, Haemorrhagic Complications.

DOI: https://doi.org/10.38124/ijisrt/IJISRT24AUG128

PDF: https://ijirst.demo4.arinfotech.co/assets/upload/files/IJISRT24AUG128.pdf

REFERENCES

  1. Ali, M. R., Salim Hossain, M., Islam, M. A., Saiful Islam Arman, M., Sarwar Raju, G., Dasgupta, P., & Noshin, T. F. (2014). Aspect of thrombolytic therapy: a review. TheScientificWorldJournal, 2014, 586510. https://doi.org/10.1155/2014/586510
  2. Lawrence, P. F., & Goodman, G. R. (1992). Thrombolytic therapy. The Surgical clinics of North America, 72(4), 899–918. https://doi.org/10.1016/s0039-6109(16)45784-1
  3. Zarar A, Khan AA, Adil MM, Qureshi AI. Anaphylactic shock associated with intravenous thrombolytics. Am J Emerg Med. 2014 Jan;32(1):113.e3-5.
  4. Takagi T, Kato T, Sakai H, Nishimura Y. Early neurologic improvement based on the National Institutes of Health Stroke Scale score predicts favourable outcome within 30 minutes after undergoing intravenous recombinant tissue plasminogen activator therapy. J Stroke Cerebrovascular Dis. 2014 Jan;23(1):69-74.
  5. Kaseer H, Sanghavi DK. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 17, 2023. Aminocaproic Acid.
  6. Collen, D., & Gold, H. K. (1990). New developments in thrombolytic therapy. Advances in experimental medicine and biology, 281, 333–354.
  7. Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Dávalos, A., Guidetti, D., ... & Toni, D. (2008). Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. The New England Journal of Medicine, 359(13), 1317-1329.
  8. Wardlaw, J. M., Murray, V., Berge, E., & del Zoppo, G. J. (2014). Thrombolysis for acute ischaemic stroke. Cochrane Database of Systematic Reviews,
  9. Nogueira, R. G., Jadhav, A. P., Haussen, D. C., Bonafe, A., Budzik, R. F., Bhuva, P., ... & Jovin, T. G. (2018). Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. The New England Journal of Medicine, 378(1), 11-21.