Complicações vasculares em pacientes submetidos a intervenção coronária percutânea precoce por via femoral após fibrinólise com tenecteplase: registro de 199 pacientes

Manuel Pereira Marques Gomes Junior, Felipe José de Andrade Falcão, Cláudia Maria Rodrigues Alves, José Marconi Almeida de Sousa, João Lourenço Herrmann, Antonio Celio Camargo Moreno, Carlos Alexandre Lemes de Oliveira, Livia Nascimento de Matos, Adriano Henrique Pereira Barbosa, Antonio Carlos Carvalho
2012 Revista Brasileira de Cardiologia Invasiva  
background: Fibrinolysis is often used in the treatment of acute coronary syndromes with ST segment elevation (STEMI). Major cardiac outcomes were reduced with antiplatelet therapy intensification, but with increased risk of bleeding. Our objective was to assess the risk of vascular bleeding in patients undergoing early percutaneous coronary intervention after thrombolysis. Methods: Between February 2010 and December 2011, five public emergency rooms in the city of São Paulo and the Emergency
more » ... and the Emergency Health Care Service (Serviço de Atendimento Móvel de Urgência -SAMU) used tenecteplase (TNK) to treat patients with STEMI. Patients were referred to a single tertiary hospital and were submitted to early cardiac catheterization during hospitalization. All examinations were performed via the femoral artery and BARC criteria were used to classify bleeding. Results: We evaluated 199 patients, of whom 193 had no bleeding of vascular origin (group 1) and 6 (3%) developed this complication (group 2). The median time between the administration of the fibrinolytic agent and catheterization was 24 hours in group 1 and 14.7 hours in group 2. According to BARC criteria, 1 patient had type 3a bleeding (hematoma in the inguinal region with a hemoglobin decrease of 3-5 g/dL), 2 patients had type 3b bleeding (1 not related to vascular access and 1 retroperitoneal hematoma
doi:10.1590/s2179-83972012000300010 fatcat:n533wxahzreb7kxxwrlejwlipa