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The first real treatment breakthrough came with the arrival of thrombolytics, colloquially known as clot-busters: drugs used to break down clots found in blood vessels.

When he reached the infirmary, the doctor there did not administer thrombolytic therapy, which could have helped dissolve the blood clots caused by his ST-segment elevation myocardial infarction.

Despite these issues, this registry study identifies a lot of problems with the increasing use of CDT, in particular the increased risk of intracranial hemorrhage is concerning and may reflect variable doses of thrombolytics.

The mortality benefit, the authors write, “must be tempered by the finding of significantly increased risk of major bleeding and ICH associated with thrombolytic therapy, particularly for patients older than 65 years.”

Because endovascular procedures were shown to be no more dangerous than IV thrombolytics, physicians may continue to perform it and assume the outcomes can only get better.