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.
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?
It is done in the Cath lab, Intensive care unit, Comprehensive
Cardiac Recovery Unit, Cardiac Progressive Care Unit, and
the Cardiac Intensive Care Unit.
How long does this procedure take?
Thrombolytic therapy takes about an hour.
Which facilities perform this procedure?
Sparrow Hospital
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