Güncel Bilgiler Eşliğinde Trombolitik Tedavi

Abstract

Trombolitik tedavi, damar içi trombüsün farmakolojik olarak eritilmesini sağlayan ve özellikle hayatı tehdit eden tromboembolik durumlarda kullanılan önemli bir tedavi yöntemidir. Fibrinolitik tedavi olarak da bilinen bu yaklaşım, plazminojenin plazmine dönüştürülmesi yoluyla fibrinin parçalanmasını sağlar ve kardiyovasküler acillerde erken reperfüzyonun sağlanmasında kritik bir rol oynar. Günümüzde trombolitik uygulamalar; pulmoner emboli (PE), akut miyokard infarktüsü (AMI) ve akut iskemik inme (Aİİ) başta olmak üzere çeşitli arteriyel ve venöz tıkanıklıklarda kullanılmaktadır. Bu tedavide zamanın belirleyici olması nedeniyle erken tanı, endikasyonların doğru değerlendirilmesi ve kontrendikasyonların hızlıca dışlanması özellikle acil serviste büyük önem taşır. Bu derlemede, son yıllarda yayınlanan güncel kılavuzlar ışığında PE, AMI ve Aİİ’de trombolitik tedavi önerileri, ajan seçimi, uygulama stratejileri, zaman penceresi ve özel durumlara yönelik yeni yaklaşımlar ayrıntılı olarak ele alınmaktadır.

Keywords

• Akut iskemik inme
• Fibrinolitik ajanlar
• Trombolitik tedavi

Supporting Institution

Bu araştırma, kamu, ticari veya kâr amacı gütmeyen sektörlerdeki fon sağlayan kuruluşlardan herhangi bir özel hibe almamıştır.

Ethical Statement

Bu çalışma etik standartlara uygun olarak yürütülmüştür.

Thrombolytic Therapy in Light of Current Evidence

Abstract

Thrombolytic therapy is a pharmacological method used to dissolve intravascular thrombi and plays a critical role in the management of life-threatening thromboembolic conditions. Also known as fibrinolytic therapy, it promotes the conversion of plasminogen to plasmin, leading to fibrin degradation and restoration of perfusion. Today, thrombolytic agents are widely used in several major clinical emergencies, particularly pulmonary embolism (PE), acute myocardial infarction (AMI), and acute ischemic stroke (AIS). Because time is crucial in achieving optimal outcomes, early diagnosis, rapid determination of indications, and swift exclusion of contraindications are essential—especially in emergency departments. This review summarizes the most recent guideline recommendations on thrombolytic therapy in PE, AMI, and AIS, focusing on indications, contraindications, agent selection, dosage strategies, timing of administration, and new imaging-based approaches for extended therapeutic windows. Advances in clinical evidence and ongoing large-scale studies continue to refine the role of thrombolysis in modern acute care.

Keywords

• Acute ischemic stroke
• Fibrinolytic agents
• Thrombolytic therapy

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