What should be included in reperfusion strategy?
Selecting the optimal reperfusion strategy requires customization based on patient factors including time from symptom onset to first medical contact (FMC), the amount of myocardium at risk, the presence of shock or severe heart failure, the risk of bleeding with fibrinolysis, and the time required to perform PCI (
What is myocardial reperfusion?
Cardiology. Reperfusion injury, sometimes called ischemia- reperfusion injury (IRI) or reoxygenation injury, is the tissue damage caused when blood supply returns to tissue (re- + perfusion) after a period of ischemia or lack of oxygen (anoxia or hypoxia).
What is reperfusion injury What is its relation to thrombolytic therapy?
Ischemia- reperfusion injury is a common feature of ischemic stroke, which occurs when blood supply is restored after a period of ischemia. Reperfusion can be achieved either by thrombolysis using thrombolytic reagents such as tissue plasminogen activator ( tPA ), or through mechanical removal of thrombi.
What is thrombolytic therapy used for?
Thrombolytic therapy is the use of drugs to break up or dissolve blood clots, which are the main cause of both heart attacks and stroke.
What is reperfusion?
Reperfusion : The restoration of blood flow to an organ or to tissue.
What are reperfusion arrhythmias?
Rhythm disorders associated with coronary occlusion are defined as ischemic arrhytmias, whereas arrhythmias occurring as the result of increased myocardial perfusion are called reperfusion arrhythmias . Accelerated idioventricular rhythm may be a marker of early reperfusion and continuing arterial patency.
How does reperfusion cause compartment syndrome?
Compartment syndrome is a clinical condition that is characterized by functional loss of muscle and nerve tissues and develops as a result of ischemia which can occur due to increased perfusion pressure within closed muscle fascia of the extremities. Tissue reperfusion after ischemia can cause reperfusion syndrome .
What is coronary reperfusion therapy?
Reperfusion therapy includes drugs and surgery. The drugs are thrombolytics and fibrinolytics used in a process called thrombolysis. Surgeries performed may be minimally-invasive endovascular procedures such as a percutaneous coronary intervention (PCI), followed by a coronary angioplasty.
What are the mechanisms of ischemia reperfusion injury?
Overview of the mechanism of ischemia-reperfusion injury. The ischemic state induces anaerobic metabolism, leading to a lower level of ATP production and failure of ion-exchange channels . Failure of ion-exchange channels leads to cell swelling and impaired enzymatic activity in the cytoplasm.
What is cerebral ischemia reperfusion injury?
Cerebral ischemia / reperfusion injury (CI/RI) is a common feature of ischemic stroke , involving a period of impaired blood supply to the brain , followed by the restoration of cerebral perfusion through medical intervention.
What is the mechanism of action of fibrinolytic or thrombolytic drugs?
Mechanisms of Thrombolysis . Thrombolytic drugs dissolve blood clots by activating plasminogen, which forms a cleaved product called plasmin. Plasmin is a proteolytic enzyme that is capable of breaking cross-links between fibrin molecules, which provide the structural integrity of blood clots.
Why is thrombolytic therapy contraindicated in hypertension?
Background. Intravenous thrombolysis (IVT) with (recombinant) tissue plasminogen activator is an effective treatment in acute ischemic stroke. However, IVT is contraindicated when blood pressure is above 185/110 mmHg, because of an increased risk on symptomatic intracranial hemorrhage.
What is the most common complication of fibrinolytic therapy?
The most feared complication of fibrinolysis is intracranial hemorrhage ( ICH ), but serious hemorrhagic complications can occur from bleeding at any site in the body. Risk factors for hemorrhagic complications include the following: Increasing age. Lower body weight.
How long does it take for thrombolytic therapy to work?
To be effective, the therapy needs to be initiated as soon as possible, before permanent damage has occurred. The length of a treatment session varies depending on the underlying cause. A session can take from 60 minutes (typical for a heart attack ) to 48 hours (often the case for deep vein thrombosis , or DVT ).
What are the side effects of thrombolytic therapy?
Besides risk of serious internal bleeding , other possible risks include: Bruising or bleeding at the access site. Damage to the blood vessel. Migration of the blood clot to another part of vascular system. Kidney damage in patients with diabetes or other pre-existing kidney disease.