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Overview

 


What Is Thrombolytic Therapy ?

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Thrombolytic therapy is a treatment used to break up dangerous clots inside your blood vessels. To perform this treatment, your physician injects clot-dissolving medications into a blood vessel. In some cases, the medications flow through your bloodstream to the clot. In other cases, your physician guides a long, thin tube, called a catheter, through your blood vessels to the area of the clot. Depending on the circumstances, the tip of the catheter may carry special attachments that break up clots. The catheter then delivers medications or mechanically breaks up the clot.

Thrombolytic therapy commonly is used to treat an ischemic stroke, which is another name for a clot in a blood vessel in your brain.

 It can also be used to Treat Clots in:
  • A lung artery, called a pulmonary embolism;
  • The deep veins of your leg, called deep vein thrombosis (DVT);
  • Your heart, which may cause a heart attack;
  • An artery elsewhere in your body, such as in an arm or leg artery; or
  • A bypass graft or dialysis catheter that has become blocked.


Your blood is normally a liquid that travels smoothly through your arteries and veins. Sometimes, however, blood components, called platelets, can form clumps and, together with other blood components, can cause the blood to gel. This process is called clotting or, more technically, coagulation. This is a normal process that protects you from excessive bleeding from even a minor injury. However, in certain circumstances blood clots can build up inside a blood vessel and block blood flow. At other times, pieces of these clots can break off, travel through your bloodstream, lodge in a blood vessel somewhere else in your body and obstruct normal blood flow. Blood clots in your heart or lungs, for example, can starve the organ and be life threatening.


Am I A Candidate For Thrombolytic Therapy ?

You may be a candidate for thrombolytic therapy if you have symptoms of a stroke, heart attack, pulmonary embolism, DVT, or a clot in an artery or bypass graft in a limb.

These symptoms may include:

  • Chest pain;
  • Numbness or tingling on one side of the body;
  • Blurred vision in one eye;
  • Slurred speech;
  • Sudden weakness;
  • Severe swelling of an arm or leg; or
  • Pain, numbness or coldness in a limb.


If you have a life-threatening clot, your physician will attempt to establish thrombolytic therapy as soon as possible after symptoms begin, preferably within 1 to 2 hours.


Am I at risk for complications during thrombolytic therapy ?

If you have diabetes or kidney disease, you may have a higher risk of complications from the contrast agents used in the angiogram. If you have kidney disease, sometimes your physician can treat you with medications or fluids before you receive contrast, to protect your kidneys and minimize the risk.

People with blood clotting disorders also may have a higher risk of complications from thrombolysis.

 Other factors that may increase the risk for complications include:

  • History of internal bleeding;
  • Pregnancy;
  • Endocarditis, an infection in the lining of the heart;
  • Advanced age;
  • Recent surgery or injury;
  • Poorly controlled hypertension; or
  • Diabetic retinopathy, a problem in the eyes that results from diabetes.



What Can I Expect After Thrombolytic Therapy ?

Usually, you will stay in bed as you recover from thrombolytic therapy. During this time, your physician and the hospital staff closely watch you for any complications. You may receive fluids, antibiotics, or painkillers. If your physician inserted the catheter through an artery in your arm or leg, you may have to hold the limb straight for several hours. Once any bleeding from the access site stops, and your vital signs are normal, you may be discharged.  Often, however, you will require further hospitalization for treatment of the underlying reason for the clot, or for adjustment of anticoagulation doses if needed to prevent clots from reforming.

If you notice any unusual symptoms after or during your procedure, you should tell your physician immediately.

These symptoms may include:

  • Arm or leg pain that lingers or gets worse;
  • A fever;
  • Shortness of breath;
  • An arm or a leg that turns blue, develops swelling or feels cold; or
  • Problems around your access site, such as bleeding, swelling, pain, or numbness.


Before your discharge, your physician will give you instructions about everyday tasks to follow after you return home. For example, you should not lift more than about 10 pounds for the first few days after your procedure. You should drink plenty of water for 2 days to help flush the contrast dye out of your body. You can usually shower 24 hours after your procedure, but you should avoid baths for a few days.

During your recovery, you may experience nausea, vomiting, or coughing. You should tell your physician if any nausea, back pain or lightheadedness lingers, because these symptoms could mean you have internal bleeding.

If you received thrombolytic therapy in an emergency, you may receive additional care for your condition. For example, if you had a stroke, your physician may prescribe medications, a special diet, or physical therapy. If you had a heart attack, your physician may need to examine your heart to see if any other arteries are blocked. If you had a blocked bypass graft, you may need further treatment or anticoagulation to keep the bypass open.


Are there any complications ?

Complications are not unusual with thrombolytic therapy, which is why it should be carried out under close supervision.

However, your physician can manage most of them, including:

  • Bleeding in the access site or elsewhere;
  • Low blood pressure; or
  • Allergy to thrombolytic drugs.





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