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Fibrinolytic therapy: A saviour in the absence of Angioplasty

Dr. Brian Pinto

Chief Cardiologist

Holy Family Hospital, Mumbai

“Every 17 seconds an Indian dies of an acute myocardial infarction and I think it is important for us to realize that we will not be able to tackle this problem by primary angioplasty alone,” says Dr. Brian Pinto. “Fibrinolytic therapy is useful in the absence of angioplasty. We now have agents like tenecteplase and alteplase, which can be administered anywhere- in homes or ambulances.” Once Fibrinolytic therapy is administered, the patient can get optimum treatment of angiography within the first 3-24 hours. This combination, known as the pharmacoinvasive therapy is as good or even better than primary angioplasty.” “It is my default mode 95% to 98% of patients,” Dr. Brian endorses the transradial approach to angioplasty. “The rival trial and matrix trial have clearly shown that the transradial approach is beneficial, with significantly reduced back pain, urinary problems and a very low rate of mortality.” Patients who are on dialysis, have significant hypotension, or have bypass grafts are some exceptions, in whose case, the transradial approach may not work.
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