Thrombolysis therapy is used to treat patients that have deep vein thrombosis (DVT) in the legs, pelvic area, or upper areas of the body.
During the procedure, Dr. Tilara injects clot-dissolving medication into the blood vessel or vein. The medication flows through the bloodstream to breakup the clot; however, if the clot does not dissolve Dr. Tilara will insert a long, thin, guided catheter into the vessel to cause the clot to break up. If DVT clots are left untreated, parts of the clot can detach and travel to an artery in the lungs, which results in acute pulmonary embolism.
About the Procedure
Prior to the procedure, patients are required to provide a full medical history, answer questions, and undergo a physical exam. Dr. Tilara will also need a list of current medications (including vitamins and dietary supplements). To make sure at a patient qualifies for thrombolysis therapy, a number of pre-procedure tests are performed including a blood workup, an echocardiogram (echo) to determine where the clot is, and a electrocardiogram (ECG) to evaluate heart rhythm.
Patients will receive instructions to follow before the procedure, including fasting. Typically, patients will not be able to eat or drink anything 6-12 hours before the procedure. Patients may also be asked to reduce or stop taking medications that would increase the risk of bleeding or other complications.
Before or as part of thrombolytic therapy, patients will have a test called an angiography preformed. This test creates an angiogram, or a picture of the blood vessels. It also uses dyes, referred to as contrast, which will eventually be flushed out through the kidneys. Patients that have kidney disease or difficulty tolerating the contrast dye, may receive pre-procedure medication to minimize or eliminate complications.
Types of Thrombolysis
- Eminase (anistreplase)
- Retavase (reteplase)
- Streptase (streptokinase, kabikinase)
- t-PA (class of drugs that includes Activase)
- TNKase (tenecteplase)
- Abbokinase, Kinlytic (rokinase)
These are all examples of clot-busting drugs that we use to inject into the affected site with a catheter. We also use a long catheter, which is inserted into the blood vessel and guided near the blood clot to distribute medications straight to the clot.
During these types of thrombolysis, our doctors use radiological images to see if the blood clot is dispersing. This treatment could take up to several hours if the clot is small; however, it may take several days for a severe obstruction.
Mechanical thrombectomy is another type of thrombolysis that we might use. During this procedure, a long catheter is tipped with a small suction cup, rotating device, high-speed fluid jet, or a ultrasound device to physically break down the clot.
Treats clots for:
- Pulmonary embolism
- Deep veins of your leg, called deep vein thrombosis (DVT)
- Artery other places in your body, like your arm or leg
- A blocked bypass graft or dialysis catheter
Dr. Tilara specializes in blood clot prevention, treatment and removal allowing patients to return to their everyday lives as quickly as possible.