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Thrombolytic Therapy

Minimally Invasive Mechanical Thrombectomy for Stroke featuring Dr. Derek Kreitel from Premier Vein on Vimeo.

Catheter-directed Thrombolysis is a minimally invasive treatment that dissolves abnormal blood clots in blood vessels to help improve blood flow and prevent damage to tissues and organs. In a catheter-directed Thrombolysis procedure, X-ray imaging is used to help guide a special medication or medical device to the site of blood clots to dissolve the blockage.

Your doctor may recommend Thrombolytic therapy to treat blood clots in arteries and veins resulting from any of these causes:

  • Thrombosis (blood clot) in the vascular bed of the diseased arteries, such as in an arm or leg artery that has severe narrowing due to atherosclerosis.
  • Deep vein thrombosis is a condition in which a blood clot forms in a main vein that returns blood flow from the arms or legs back to the heart and lungs. This type of clot may grow big enough to completely block the vein, posing serious risk if part of it breaks off and travels to the lungs (called pulmonary embolism).
  • Slowed circulation caused by heart disease, which can allow a blood clot to form in one of the heart's chambers. A clot that breaks loose, travels through the bloodstream and lodges in either an organ or artery forming a complete blockage in blood flow at that point is called an embolism.
  • Thrombosis of the dialysis fistulas or grafts.
  • Pulmonary embolism.
  • Thrombosis of the portal vein and other mesenteric veins.

Prior to your procedure, your blood may be tested to determine how well your liver and kidneys are functioning and whether your blood clots normally. You will receive specific instructions on how to prepare, including any changes that need to be made to your regular medication schedule. You will be admitted to the hospital on the morning of your procedure and be assessed by the interventional radiologist before the procedure begins. Dialysis fistula or graft Thrombolysis patients are generally discharged the same day; however, most other conditions require hospitalization for several days with careful monitoring. You will be given a gown to wear during the procedure.

In this procedure, an X-ray camera, catheter, special medications and a medical device that dissolves blood clots may be used. A catheter used for thrombolysis is a long, thin, hollow plastic tube, about as thick as a strand of spaghetti. These catheters are designed so that blood dissolving medications can be delivered effectively within the blood clot. There also are medical devices that can be used to dissolve the clots mechanically. Your interventional radiologist will decide which technique is most appropriate for your condition. Other equipment that may be used during the procedure includes an intravenous line (IV) and equipment that monitors your heart beat and blood pressure.

Using X-ray guidance and a contrast material that helps define the blood vessel, your physician will insert a catheter through the skin into a vessel (artery or vein) and maneuver it to the site of the thrombosis, or blockage.

The blood clot will then be dissolved in one of two ways:

  • By delivering medication directly to the blood clot
  • By positioning a mechanical device at the site to break up the clot

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