heparin during tPA

[lightthelamp4]

Hi guys,
so I was hoping for come clarification on how heparin and tPA are used in relation to each other.
I read (in a review article in cirulation journal) that for massive PE you turn off your heparin drip while tPA is running and then wait for the PTT to be less than 80 before restarting heparin after tPA is done. The same reference I was reading said that this is in contrast to tPA for STEMI, in which case you would let the heparin run while giving tPA. Just wondering if you guys do this in practice, if you know why you leave it on for MI but turn it off for PE and also what you do with heparin when running tPA for CVA.
(I am a soon to be EM intern, sorry if this is an annoying question)

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[deleted547339]

No one knows...

 

[Arcan57]

It's not a clean kill to leave it running but there's no way to get the numbers to power a study that would answer that question for PE and it would be improbable to enroll enough for CVA.

 

[lightthelamp4]

ok thanks guys, I was just checking to make sure I wasnt missing something very basic that everyone else knows