Anticoagulation as Adjunctive Treatment and One-Hour Alteplase Infusion

  • Carlos Jerjes-SánchezEmail author
  • Anabel Garcia-Sosa


Adjunctive treatment in the setting of cardiovascular thrombolysis is the cornerstone to avoid recurrence establishing a bridge to starting oral anticoagulation with oral vitamin-K antagonists or activated factors anticoagulants. In addition, bleeding complications in the first 20- or 48-h could be related with the adjunctive treatment. So, it is important that physicians linked with PE patients care choose the best option. In this chapter the position of European and North American societies will be analyzed. Also, experiences with fondaparinux and unfractionated heparin regimen use in ST-myocardial infarction patients will be analyzed. Additionally, based on our previous successful experience with ST-elevation myocardial infarction regimen with a first generation fibrinolytic, we decided to use recombinant human tissue-type plasminogen activator in PE patients with efficacy and safety, as has been used in myocardial infarction patients. Although we did not have head-to head studies, less residual thrombosis with recombinant human tissue-type plasminogen activator compared with a first generation fibrinolytic was observed.


Thrombolysis Unfractionated heparin Low-molecular-weight heparin Fondaparinux Enoxaparin 


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© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Instituto de Cardiologia y Medicina Vascular, TEC SaludSan Pedro Garza GarciaMexico
  2. 2.Escuela de Medicina, Tecnológico de MonterreySan Pedro Garza GarciaMexico
  3. 3.Unidad de Investigacion Clinica en Medicina SCMonterreyMexico
  4. 4.Department of Emergency RoomHospital de Cardiologia No. 34, Instituto Mexicano del Seguro SocialMonterreyMexico

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