What Is Thrombolysis?

J.M. Willhite

Thrombolysis is a therapeutic treatment used to dissolve life-threatening blood clots. Often used to treat thrombophlebitis, thrombolysis may also be used to dissolve blood clots that can cause a heart attack or stroke. As with any invasive treatment, thrombolysis does carry risks for complications, including infection.

Blood clots may be dissolved with thrombolysis.
Blood clots may be dissolved with thrombolysis.

There are several approaches used in thrombolytic therapy. Generally, clot-dissolving drugs are injected directly into the clot by a catheter. Once the drug is introduced it goes to work to reduce the size of the clot so proper blood flow may be restored to the affected blood vessel or artery. According to WebMD, there are several drugs used as part of thrombolytic therapy, including streptokinase, anistreplase and tenecteplase. Additional drugs, including alteplase and reteplase, may also be given in thrombolytic therapy.

Ideally, thrombolysis should be administered soon after symptoms of stroke or heart attack arrise to reduce the amount of damage sustained. Individuals who suffer a heart attack or stroke usually undergo thrombolysis soon after arriving at the hospital. Thrombolysis may be administered via a catheter or through mechanical thrombectomy, which may use motion or ultrasound to actually collapse the targeted blood clot.

The type of clot-busting drugs given is determined by the individual’s known medical history and age. Those who have bleeding conditions, such as ulcers, unregulated hypertension or are on blood thinners may not be able to undergo thrombolytic therapy. Treatment approach in such situations is left entirely to the attending physician’s discretion.

Imaging technology, including computerized tomography (CT) scan and ultrasound, are diagnostic tools used to detect and evaluate blood clots. Once the clot is located and assessed, appropriate treatment options may be discussed. If a life-threatening clot is found in a major artery or vein that supplies the heart or brain, immediate thrombolytic therapy is necessary to prevent complications.

Blood clots may form in the wake of venous injury or in the presence of conditions that impair the blood’s ability to clot. Poor circulation, which can be accentuated by prolonged periods of inactivity, is a common contributory factor for blood clot formation. When blood circulation is impaired or slowed, blood has an opportunity to accumulate in the veins and clot.

Depending on their location and size, blood clots can place a person at risk for pulmonary embolism, deep vein thrombosis (DVT) and clot dislodgment, which allows the clot the opportunity to travel to the brain or heart resulting in stroke or heart attack. Thrombophlebitis is a condition where blood clots contribute to vein swelling, which impairs blood flow. Regardless of the location of the blood clot, if it poses a threat to one’s life, thrombolytic therapy is the ideal course of treatment.

Overall, thrombolytic therapy is considered a safe procedure, although there are some risks associated with its use. Some individuals may experience infection, bruising or bleeding at the injection site. If thrombolysis is performed during neurology procedures, there is a chance intracranial bleeding may occur. Thrombolysis does not treat vessel injury caused by the presence of the clot; therefore, additional treatment may be necessary.

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