Thrombolytic Therapy: Current Status

Therapeutic IssuesRegionalization of TherapyThe possibility of increasing thrombolysis without causing bleeding has motivated efforts to direct therapy selectively to the pathologic thrombus. Two approaches that have been tried are administration of agents that may bind selectively to a thrombus, and regional infusion of agents into the occluded vessel in order to restrict therapy anatomically to the thrombus. Both methods have theoretical advantages, but experience has revealed practical problems with each technique.The concept that the effects of thrombolytic therapy on the coagulation mechanism initiate bleeding provided the rationale for the use of fibrin-selective agents, each of which exploits . . .