Coronary Thrombolysis— It's Worth the Risk

摘要: ALTHOUGH the concept of coronary thrombolysis for treatment acute evolving myocardial infarction has been extant over three decades, 1 it is only in last few years that profound benefits have consistently documented large numbers patients, reflected by improved left ventricular function, 2-5 decreased incidence and severity congestive heart failure, 5 late fatal arrhythmias, 6 short- 7-10 long-term 11,12 mortality. However, as with any medical or surgical treatment, pharmacologic activation fibrinolytic system entails a risk—in its case, primary risk being bleeding. This not "side effect" but direct consequence desired action when lytic agents are administered, ie, fibrin degradation clot dissolution. Unfortunately, plasmin cannot be confined presently to pathological deposits fibrin, protective thrombi also will disrupted. Nevertheless, spontaneous bleeding (gastrointestinal, genitourinary, retroperitoneal,