What is thrombolysis?
Thrombolysis is a form of drug therapy used to treat blood clots. Medications are administered through an IV or catheter to dissolve the clots. Vascular surgeons use MRI or CT scans during the therapy to make sure the “clot buster” drugs are effective.
Why would you need thrombolytic therapy?
Thrombolysis is used in emergency situations when blood flow is obstructed, as in a heart attack, stroke or pulmonary embolism. It may be a necessity to quickly get the blood flowing normally again or if stenting or surgery is not an option. Thrombolytic therapy can also treat other, non-emergency conditions like deep vein thrombosis or peripheral artery disease.
Doctors use three types of thrombolysis to treat these different issues:
- Systemic thrombolysis delivers medicine to your bloodstream intravenously. It’s the preferred method in emergency scenarios because it works quickly.
- Catheter-directed thrombolysis is used in scheduled procedures to treat thrombosis or peripheral artery disease. A catheter is run up to the affected artery, delivering medication right to the blood clot.
- Mechanical thrombectomy is a slightly different procedure in that the clot is sucked up through a catheter or broken up by it. It can be used along with catheter-directed thrombolysis to first dissolve a blood clot with medication before suctioning the remains out.
Are there any risks of complications of thrombolytic therapy?
The risks of not receiving thrombolytic drug therapy are life-altering — even life-threatening. You could lose a limb, suffer a disability or die. Undergoing thrombolysis is much less risky, although there is a small chance of a brain bleed that causes a stroke.
More common complications include:
- Bleeding internally or at the site of the catheter or IV
- Low blood pressure
- Movement of the blood clot to another part of the body
- Swollen tissue
- Kidney damage
- Abnormal heart rhythms
How do you prepare for thrombolysis?
More often than not, thrombolysis is used in emergency situations where there’s no time to prepare. Your vascular team must act fast — within two hours of heart attack, stroke or pulmonary embolism symptoms — to deliver the drugs to bust the blood clot.
In non-emergency scenarios, you may be asked to follow standard guidelines for when you receive drugs during a procedure, such as fasting or changing your medication schedule.
What should I expect after receiving thrombolysis?
Thrombolysis is an effective short-term treatment for blood clots. It can quickly resolve any symptoms resulting from restricted blood flow. But it is a treatment for one symptom, not the underlying cause.
For that reason, further treatment may be necessary to:
- Treat the disease causing blood clots
- Dissolve clots that develop elsewhere (or move) within the artery
- Thin the blood to prevent future clots
- Remove other blockages or place stents to improve blood flow
Follow-up testing will determine whether the thrombolytic therapy worked and what underlying issues may warrant additional treatment.