What is Thrombolytic Therapy?

Thrombolysis or thrombolytic therapy is the administration of drugs (“clot busters”) targeting to dissolve blood clots that have acutely (suddenly) blocked major arteries or veins with potentially serious or life threatening implications. These include:

  • Blocked arteries of the brain - stroke
  • Blocked arteries of the heart - heart attack
  • Blocked arteries of the lung - pulmonary embolism
  • Blocked arteries of the leg – acute leg ischemia (restricted blood flow - risk of amputation)
  • Blocked veins of the leg – deep vein thrombosis
  • Blocked bypasses, blocked dialysis fistulas or catheters

Thrombolysis is usually an emergency treatment. In order to be effective, it needs to be initiated as soon as possible, before a permanent damage has occurred and before the clot gets too stiff and cannot be dissolved. The drugs must be given within a few hours of the beginning of a stroke, a heart attack (ideally within 30 minutes), leg ischemia or pulmonary embolism and up to 2 weeks in deep vein thrombosis. Thrombolytics if administered on time and break down the clot, they are anticipated to:

  • Reverse or reduce the symptoms of a stroke by restoring brain blood flow
  • Protect the heart from an evolving heart attack by restoring heart blood flow
  • Reverse lung damage and heart failure in pulmonary embolism by restoring lung blood flow
  • Reestablish blood flow and prevent major surgery or limb loss in case of acute leg ischemia
  • Unblock the clotted leg veins in deep vein thrombosis and prevent post thrombotic syndrome (leg swelling, heaviness, non-healing ulcers)
  • Unblock clotted bypasses, dialysis fistulas or catheters

The most frequently used thrombolytic drugs are: tissue plasminogen activator (alteplace), urokinase, streptokinase, rokinase, reteplace, tenecteplace and anistreplace There are two ways these clot-busting agents can be administered: through a peripheral IV (systemic thrombolysis) or through a catheter (thin tube) that has been navigated into the clot.

 

vascular health

Vascular Surgeon

Dr. Efthymios (Makis) Avgerinos is a Vascular Surgeon, Associate Professor of Surgery in the Division of Vascular Surgery, University of Pittsburgh School of Medicine in USA.

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Scientific Editing

Efthymios D. Avgerinos, MD, PhD, FEBVS
Associate Professor of Surgery
Division of Vascular Surgery, University of Pittsburgh
Medical Center Pennsylvania, USA

E-mail: info@vascularhealth.gr