Thrombolytic Treatment
Why
is the doctor performing this procedure?
To directly
inject medicines capable of breaking apart harmful, rigid blood clots. This
therapy can be life-saving during or shortly after a heart attack.
What
is the procedure?
"Thrombus"
is blood clot; "lytic" or "lysis" means to break apart. So, thrombolytic
therapy is used to break up a blood clot that is causing partial or full
obstruction of blood flow in an artery. A blood clot in a brain artery can
lead to stroke; a blood clot in a heart artery can lead to a heart attack.
There are
two methods of thrombolytic therapy: Intravenous (IV) and catheter-based.
IV therapy
involves placement of an IV line in a vein to disperse medication
throughout the body. This technique is used to destroy blood clots in
non-specific areas (often in patients having a heart attack). Following
slow perfusion of the medication, the IV lines are removed. Removal can
only occur once fibrinogen levels (blood clotting levels) return to normal
(usually the next day).
For precise
delivery of medicine directly to a blood clot, a catheter-based approach is
used. During this procedure, a perfusion catheter is inserted into an
artery, usually in the groin (the femoral artery). It is then advanced to
the blood clot. Once properly positioned, the medicine is injected thru the
catheter and into the clot, where it begins to destroy the clot
immediately. As the clot disappears, blood flow resumes. One may still see
a plaque or a hard clot. If a plaque is present, this may indicate the need
for further treatment (See angioplasty ). In some
cases, thrombolytic therapy is used to soften, hard (difficult to break)
blood clots. Once the clot is softened, your doctor may crush the clot
using an angioplasty or atherectomy technique.
Once the
blood levels are normalized, the catheter is removed, and pressure is
applied to the catheter site to stop bleeding. Some examples of
thrombolytic medicines used for this procedure include:
- Alteplase
- Retenplase
- Streptokinase
- Urokinase
- Eminase
- TPA (Tissue Plasminogen Activator)
Where
is the procedure performed?
In the
Cardiac Catheterization Lab or Interventional Radiology Suite.
How
long does this procedure take?
Thrombolytic
therapy takes about an hour.
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