Resumo

HERNANDEZ, César et al. Colombian consensus on selective thrombolysis with catheter in thromboembolic vascular disease. Rev. Colomb. Cardiol. [online]. 2020, vol.27, n.1, pp.55-65. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2019.03.007.

In patients with arterial or venous thrombosis, in situ or due to an embolism, the use of fibrinolytics (such as recombinant tissue-type plasminogen activator, rtPA) administered directly into the clot through a selective catheter into the occlusion site. This can lead to a more rapid resolution of the thrombotic or embolic occlusion with a lower dose of the fibrinolytic agent, and therefore with less problems with haemorrhages than with systemic use.

The situations in which selective fibrinolysis with a catheter can be considered are mainly, acute ischaemia of a limb due to a blocked artery, pulmonary thromboembolism, proximal ileo-femoral deep venous thrombosis, proximal axillo-subclavian deep venous thrombosis, and in the thrombosis of the venous access for dialysis It is also indicated in paediatric patients in cases of arterial thrombosis or embolisms with an ischaemic limb, and in selective cases of proximal deep venous thrombosis of the limbs.

In this consensus, a description will be given of each one of the indications, with a protocol for the management with rtPA in each one of them, as well as monitoring its use and the management of haemorrhage complications.

Palavras-chave : Selective fibrinolysis; rtPA; Thromboembolisms; Infusion catheter.

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