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Salvaging lung tissue is not the aim in pulmonary embolism , Hence Time window is a myth !

There is a time window for thrombolysis in myocardial infarction ( STEMI). This time window is to salvage myocardium before it dies.The average time window in STEMI is 12 hours. When does the lung start dying in Pulmonary embolism ?.Is salvaging lung tissue an aim in the management of pulmonary embolism ?. Not really .Lung parenchymal death occurs only in minority of patients with pulmonary embolism .

The bronchial artery continue to supply the lungs.

So the aim here is to restore pulmonary circulation and oxygenation. Hence there is no strict time window in the management of pulmonary embolism.

The General consensus is , one can attempt thrombolysis up to 7 days after diagnosing pulmonary embolism.

Beyond this time, it is believed thrombus gets organised and thrombolytic agents may be ineffective.

But this is only an assumption, in an individual patient thrombolysis may be done even beyond this period if warrented by clinical intuition .

Dr .S.Venkatesan .Madras medical college, Chennai.India .

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