Thrombolysis (thrombolytic therapy)

What is thrombolysis (thrombolytic therapy)?

Thrombolysis, also known as thrombolytic therapy or fibrinolytic therapy, is a treatment that dissolves blood clots to restore normal blood flow. This approach is used in emergencies, such as heart attacks, strokes, and severe blood clots in the lungs or legs. Thrombolytic drugs, sometimes called clot-busting therapy, are administered through an intravenous (IV) line or directly into the blood clot through a catheter. By quickly breaking down the clot, thrombolysis can help prevent damage to tissues and organs.

Penn Medicine physicians have extensive experience in treating all types of blood clotting disorders. We provide customized care for emergency and chronic blood clotting problems to offer you the best outcomes possible.

Types of thrombolytic therapy

The three main types of fibrinolytic therapy are systemic thrombolysis, catheter-directed thrombolysis, and mechanical thrombectomy.

Who is a candidate for thrombolytic therapy?

ombolytic therapy may be an option for people with blood clots who need urgent treatment to restore blood flow and prevent severe complications, such as those experiencing:

What to expect during a thrombolysis procedure

Before your thrombolytic therapy procedure, your provider will explain how it’s done and give you time to ask questions. In preparation for the procedure, your doctor will review your medications with you and discuss your health history.

Patients receiving systemic thrombolysis usually stay in Penn Medicine’s specialized cardiac intensive care unit (ICU). We deliver the clot-busting thrombolytic drugs through an IV line in your arm. Our experts closely monitor your breathing and heart function and continually watch for excessive bleeding during your treatment.

Patients receiving catheter-directed thrombolysis or mechanical thrombectomy can typically expect:

  • An IV line will be placed for medication administration. Depending on the procedure’s complexity, local anesthesia or sedation may be used. The medical team will be by your side the entire time to ensure your comfort.
  • In catheter-directed thrombolysis, a thin catheter will be inserted into a blood vessel, usually in your groin or arm, and guided to the clot site using imaging techniques like x-rays. Once in place, a clot-dissolving medication will be delivered through the catheter directly to the clot.
  • In mechanical thrombectomy, a specialized catheter is used to break up or remove the clots. Surgeons may also deliver clot-dissolving medication through the catheter.
  • Once the procedure is complete, the catheter will be removed. You’ll be taken to a recovery area for observation, where you’ll be monitored for several hours.

Recovering from a thrombolysis procedure

After a thrombolysis procedure, your recovery will depend on your situation and the type of treatment you received. Depending on your condition, you might go home the same day or stay in the hospital longer.

It’s important to avoid strenuous activities and follow your doctor’s advice during this time. Make sure to attend any follow-up appointments to see how you’re healing and how well the treatment worked. You may also be given medications to help prevent new clots from forming. Your health care team will provide specific instructions to support your recovery.

Thrombolytic therapy risk factors

A thrombolysis procedure effectively treats blood clots but carries some risks, such as bleeding at the injection site. There’s also a risk of internal bleeding, which can lead to stroke in rare cases. Other concerns include an allergic reaction, complications related to pre-existing conditions, or tissue damage from restored blood flow. It’s essential to discuss your medical history and any potential risks with your doctor.

Advanced blood clot care at Penn Medicine

At Penn Medicine, our vascular surgeons, cardiologists, and interventional radiologists bring together the expertise needed to identify the cause of a blood clot and restore healthy blood flow. When you choose the Penn Vascular Surgery and Endovascular Therapy Program, you’ll receive care tailored to your needs.

With highly respected vascular laboratories, we offer precise imaging that helps us accurately assess and address blood clot issues, allowing for customized therapy. Our dedication to advanced research also means you can access innovative treatments, including those developed through clinical trials. Additionally, our Advanced Limb Preservation Program focuses on preventing amputation and preserving limb health for patients facing chronic blood flow problems due to blood clots.

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