Thrombolysis (also known as the thrombolytic therapy) is breakdown of blood clots by pharmacological means. It performs by stimulating fibrinolysis by plasmin through infusion of analogs of tissue plasminogen activator (TPA). TPA is the protein that usually activates plasmin.
DISEASES IN WHICH THROMBOLYSIS IS USED
Some of the diseases in which Thrombolysis is used are as follows:
Acute limb ischaemia
Massive pulmonary embolism
Stroke (ischemic stroke)
Thrombolysis is normally intravenous, which may also be used during an angiogram (also referred to as intra-arterial thrombolysis) in case of patients present with strokes beyond 3 hours. It is performed by various medical specialists such as interventional radiologists, interventional neuroradiologists, vascular surgeons, neurosurgeons and cardiologists.
Thrombolysis is also used to treat blood clots in:
- Dialysis catheters
- Bypass grafts
- Veins that cause clots or DVT (Deep Vein Thrombosis) in pelvic area, legs and upper extremities.
TYPES OF THROMBOLYSIS
Thrombolytic agents are the most commonly used clot-busting drugs. They include:
- Abbokinase, Kinlytic (rokinase)
- Retavase (reteplase)
- t-PA (class of drugs that includes Activase)
- Streptase (streptokinase, kabikinase)
- Eminase (anistreplase)
- TNKase (tenecteplase)
To choose any kind of thrombolysis, doctors have to do it very carefully, depends on various circumstances. They usually insert a long catheter into the blood vessel and guide it near the blood clot so that they could deliver medications to the clot directly. They can also choose to inject clot-busting drugs in to the access site through a catheter.
RISKS INVOLVED IN THROMBOLYSIS
It’s well-known fact that thrombolysis is used to improve blood flow in a safe and effective manner as well as it’s also use to relieve or eliminate symptoms in many patients without the need for more invasive surgery. In spite of these benefits, thrombolysis is not recommended for everyone. It is not recommended for the patients in following cases:
- Active bleeding or severe blood loss
- Recent surgery
- Severe high blood pressure
- Severe kidney disease
- Hemorrhagic stroke from bleeding in the brain