Résumé
Therapy for submassive pulmonary embolism (intermediate risk), remains controversial. New evidence has appeared that may help us in the process of decision making. We review the relevant literature, outline prognostic factors, and discuss current recommendations and controversies regarding the available alternatives such as systemic and catheter-directed thrombolytic use.
Sujets)
Humains , Embolie pulmonaire/thérapie , Traitement thrombolytique/méthodes , Fibrinolytiques/classification , Fibrinolytiques/usage thérapeutique , Facteurs de risque , Thrombectomie , Résultat thérapeutiqueRésumé
The current evidence suggests that aspirin is treatment of choice when compared to anticoagulants for patients with non-cardioembolic stroke. The usefulness of combination therapy (aspirin vs. with or without warfarin) is still debated. Likewise the combination of Aspirin with clopidogrel has no added advantage (MATCH Trial). However anticoagulant therapy significantly benefits high-risk patients with atrial fibrillation in the elderly subjects whereas aspirin may still be the drug of choice in stroke prevention in low risk group in the younger age. There is dire need for well planned randomized double blind controlled studies to define the role of Antithrombotic agents in "cryptogenic stroke" (PFO/ASD related) antiphospholipid antibody syndrome, arterial dissections and intraluminal clot syndromes. Evaluation and treatment of associated risk factors in all categories needs greater emphasis.
Sujets)
Anticoagulants/usage thérapeutique , Acide acétylsalicylique/usage thérapeutique , Encéphalopathie ischémique/traitement médicamenteux , Fibrinolytiques/classification , Humains , Appréciation des risques , Facteurs de risque , Accident vasculaire cérébral/traitement médicamenteuxRésumé
El texto que se presenta se dedica a analizar la composición de los fibrinolíticos, su mecanismo de acción, sus indicaciones y contraindicaciones más importantes y destaca las acciones de enfermería ante pacientes con este tratamiento