Introduction |
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Indications |
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Contraindication |
Contraindications to Pharmacologic Thrombolysis (t-PA infusion)
In the presence of a contraindication to thrombolysis, the potential risk should be evaluated against the risk of not treating the thrombosis.
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Interventional Modalities for Thrombosis Management |
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Pre-Procedure |
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Labs |
Baseline laboratory Documentation
Baseline laboratory Documentation
An urgent ICU/ICP bed is reserved for the patient by the referring service. Alternatively, and based on the approval of the hematology service, the patient can be transferred to the hematology floor (6W). The patient is kept on clear diet or NPO throughout the treatment course. |
Technique |
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Figure
Complications |
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Post-Procedure |
Orders
The post-procedure thrombolysis plan is included in the IR list in Powerchart.
Labs
Bleeding Check Q 15 min:
Management of major bleeding Associated with major hemodynamic instability or affects life-threatening organ (such as the brain and the lungs).
Management of moderate bleeding Profuse with no major hemodynamicinstability or involvement of life-threatening organ.
Management of minor bleeding Slow oozing of blood (e.g. around the vascular sheaths, from old puncture sites, mild hematuria, positive occult blood in stool, etc.)
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Angiographic Follow-up |
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If further thrombolysis is no longer recommended, the sheath and catheters should be removed. Urgent CBC and coagulation studies should be obtained prior to arterial sheath removal. Arterial access may require lengthy manual pressure. Applying pressure dressing devices (e.g. Safeguard, an inflatable bulb contained within an adhesive bandage) to the puncture site can be helpful.