PCI following Thrombolytics

[dggopal]

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So I am an IMG coming from an institution that lacked a cath lab so pardon my question if it sounds rediculous. Simply as a point of understanding I wanted to know if PCI was contraindicated following administration of thrombolytics, as MTB states lytics should be within 30 mins and PCI within 90. Supposing lytics were given and there is not an adequate reduction in angina or perhaps to visualise vessle occlusion to decide on cabg etc.

 

[Trogghunter]

If you have the option for PCI, you shouldn't have given thrombolytics in the first place...that's my thought. To answer your question though, if you're at a center which doesn't have PCI and you thrombolyze, you transfer to a center with PCI if thrombolysis (no improvement in 30mins) fails. These are guidelines from the Washington manual. I don't know the contraindications to PCI, there may not be any/many because the alternative is MI, but thrombolytics have a large list of contraindications and complications.

On a side note, using small doses (subtheraputic for MI) may be beneficial for medium sized PEs.

Sent from my Nexus 7 using SDN Mobile

 

[evilbooyaa]

It is not contraindicated AFAIK, although as stated earlier, if you can PCI them initially, then you skip thrombolytics all together. Thrombolytics are really falling out of favor due to their side effect profile.