Do you consider thrombocytopenia a contraindication for fibrinolytic therapy for a massive PE?
Does your platelet threshold (if it exists) differ between Catheter Directed Thrombolysis (CDT) vs. Intravenous Systemic Thrombolysis (IVT)?
2 Answers
Mednet Member
Hospital Medicine · Baylor University Medical Center
Answered on
If one has access to mechanical thrombectomy devices and operators, they should be considered before systemic thrombolytics unless the massive PE is causing imminent danger to the patient/patient is going to code/die, in which case the risk of dying from said PE is higher than potential bleeding eve...
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Mednet MemberInvited Expert
Pulmonology · Temple University Hospital
Answered on
Agree. MT is the preferred modality, as it can be done with AC. But obviously it’s a code or dying situation, then ST may be needed. ECMO is another option that can be done as an alternative to ST. Can consider low-dose ST, depending on how sick the patient is and how fast the drug needs to go in. T...
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