PLATELETS AND THROMBOLYTIC THERAPY

FIBRINOLYTIC therapy is a major advance in the treatment of occlusive vascular disease. Problems remain, however, including resistance to fibrinolytic therapy, delays in reperfusion, reocclusion after successful thrombolysis, and serious hemorrhage.1 2 3 Increasing evidence indicates that platelets have an important role in both delaying reperfusion and mediating reocclusion. In addition, preliminary data suggest that some thrombi resist lysis because they are rich in platelets and that platelet dysfunction contributes to the hemorrhagic diathesis associated with thrombolytic therapy. It is worthwhile, therefore, to review the complex interrelations between platelets and fibrinolysis, with emphasis on the therapeutic potential (and risks) of combining thrombolytic. © 1990, Massachusetts Medical Society. All rights reserved.