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Hamostaseologie 1992; 12(02): 047-051
DOI: 10.1055/s-0038-1660315
DOI: 10.1055/s-0038-1660315
Übersichtsarbeit/Review Articles
Ist die intrakoronare Thrombolyse heute noch aktuell?
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Publication History
Publication Date:
26 June 2018 (online)
Zusammenfassung
Die intrakoronare Thrombolyse kann thrombotisch verschlossene Infarktgefäße zu einem hohen Prozentsatz rekanalisieren. Dies gelingt mit einer relativ geringen Gesamtdosis von Thrombolytika im Vergleich zur i.v. Gabe. Sie ist aber logistisch sehr aufwendig und kann nur einem Teil der Infarktpatienten zukommen. Zudem entsteht ein Zeitverlust von 40-60 Minuten gegenüber der i. v. Lyse, der durch die intrakoronar raschere Reperfusion nicht wettgemacht wird. Auch nach i. c. Lyse tritt ein globaler Gerinnungsdefekt ein, Blutungskomplikationen sind nicht nachweislich seltener als nach i. v. Kurzlyse. Beim akuten Herzinfarkt ist deshalb heute die i.v. Thrombolyse vorzuziehen.
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