When do you use thrombolysis vs PCI?
Alternatively, PCI is preferred if the medical contact-to-balloon time is less than 90 min and the delta time is less than 60 min, or if there are other reasons (eg, contraindications to thrombolysis, symptom onset of more than 3 h or high-risk STEMI [cardiogenic shock, or Killip class 3 or greater]).
Is PCI the same as thrombolysis?
Primary PCI was superior to thrombolytic therapy in our trial, in the 3 largest previously reported randomized trials,1-3 and in the latest meta-analysis of all randomized trials. Although the incidence of outcomes differs among these studies, the direction of benefit was the same, all favoring primary PCI.
Why would thrombolytic therapy be chosen over a percutaneous cardiac intervention?
Thrombolytic therapy (TT) or primary percutaneous coronary intervention (PCI) is used to restore patency and re-flow of blood in the coronary artery occluded by thrombus during STEMI. The main goal of the reperfusion is to reduce the time of total ischaemia by appropriate and timely treatment [5].
Why is PCI preferred over Fibrinolytics?
Studies have shown that compared with fibrinolytics, patients who undergo primary PCI have a lower rate of mortality, reinfarction, and hemorrhagic stroke.
What is PCI in ACS?
Practice Essentials. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD).
When are thrombolytics contraindicated?
Absolute contraindications for thrombolysis include the following: Gastrointestinal (GI) bleeding within the past 6 months. Active or recent internal bleeding. History of hemorrhagic stroke.
Is thrombolysis the same as fibrinolysis?
Thrombolytic treatment is also known as fibrinolytic or thrombolysis to dissolve dangerous intravascular clots to prevent ischemic damage by improving blood flow.
What is primary PCI in STEMI?
Primary percutaneous coronary intervention (PCI) refers to the strategy of taking a patient who presents with STEMI directly to the cardiac catheterization laboratory to undergo mechanical revascularization using balloon angioplasty, coronary stents, aspiration thrombectomy, and other measures.
What is PCI in a STEMI?
There is general consensus that emergency percutaneous coronary intervention (PCI) is the preferred treatment for patients with ST-elevation myocardial infarction (STEMI), so long as it can be delivered in a timely fashion, by an experienced’ operator and cardiac catheterization laboratory (CCL) team.
When is PCI recommended for STEMI?
Primary PCI should be performed in patients with STEMI and ischemic symptoms of less than 12 hours’ duration who have contraindications to fibrinolytic therapy, irrespective of the time delay from FMC.
Which thrombolytic for stemi?
Alteplase is FDA-approved for treatment of ST-elevation myocardial infarction (STEMI), AIS, acute massive PE, and occluded CVADs. At present, it is the only thrombolytic drug approved for AIS. In theory, alteplase should be effective only at the surface of fibrin clot.
How is thrombolysis administered?
Articles On Thrombolysis Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage.
When should PCI be performed in STEMI patients?
If high-quality primary PCI can be delivered within 120 minutes of first medical contact it is preferred to fibrinolytic therapy for most patients with STEMI. Ideally, PCI should be performed within 90 minutes from the time of first medical contact. If thrombolysis is planned it should be delivered within 30 minutes of hospital arrival
What is the difference between thrombolysis and PCI?
When compared according to risk profile, high-risk patients receiving primary PCI showed a relative reduction in mortality of 45.7% compared with thrombolysis, but intermediate- or low-risk patients fared equally well with either procedure (table 1).
Why is thrombolysis important in STEMI?
Thrombolysis in STEMI Important to rapidly recognize patients with an acute STEMI as time matters in saving myocardium and lives. Clinicians need to be vigilant in recognizing ECG’s and know when to consider thrombolysis. When available percutaneous coronary intervention (PCI) is preferred to thrombolysis.
When to use fibrinolytic therapy for STEMI?
If high-quality primary PCI can be delivered within 120 minutes of first medical contact it is preferred to fibrinolytic therapy for most patients with STEMI. Ideally, PCI should be performed within 90 minutes from the time of first medical contact. No Contraindications!