Intermediate to high risk

Systemic fibrinolysis

r-tPa(Actilyse): 0,6 mg/kg (not > 50 mg) in 15 mn, in association with continous i.v. heparin with an initial dose of 400 UI unfractionned heparin/kg/day.

If high risk of bleeding, transfer patient for percutaneous catheter invasive treatment.

Then: Anticoagulation

AVK: Acenocoumarol (Sintrom) ou Phenprocoumone (Marcoumar) following treatment initiation with unfractionned heparin or Fondaparinus (Arixtra).

or

1. Rivaroxaban (Xarelto): 20 mg/day.
2. Dabigatran (Dabigatran): 2 x 150 mg/day.
3. Edoxaban (Lixianan): 30 ou 60 mg/day.