What is Thrombolysis?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Thrombolysis?
Thrombolysis or thrombolytic therapy is a type of treatment done to dissolve the dangerous clots in the blood vessels, improving the flow of blood, and preventing damage to the organs and tissues.
Thrombolysis involves the use of certain medications to break up or dissolve a blood clot that is formed inside a blood vessel. Blood clots can grow, break loose, and cut off the blood supply to the tissues and organs. This can lead to a heart attack, stroke (the blood supply to the brain is stopped), and other serious health issues. Thrombolysis may be used as a scheduled treatment or in case of an emergency, depending on the condition of the patient.
Although thrombolysis is a minor procedure, it may still involve some risks.
In this article, we will be discussing thrombolysis in detail-
- What are the different types of Thrombolysis?
- What is the purpose of Thrombolysis?
- What are the contraindications of Thrombolysis?
- What is the diagnostic procedure before Thrombolysis?
- How to prepare for Thrombolysis?
- What is the procedure of Thrombolysis?
- How to care after Thrombolysis?
- What are the risks of Thrombolysis?
- What is the cost of Thrombolysis in India?
What are the different types of Thrombolysis?
The different types of thrombolysis are:
Catheter-based thrombolysis:
- The doctor makes an incision in the groin region through which the doctor inserts a catheter (a thin, long tube).
- The doctor guides the catheter to the site of the blood clot.
- Medications are injected through the catheter, or special instruments are used to break up the blood clot.
Intravenous thrombolysis:
- The doctor injects medicines through an IV (intravenously), that is, directly into the vein.
- The medicine travels to the blood clot site to break it up or dissolve it.
What is the purpose of Thrombolysis?
Thrombolysis is used in the treatment of the following:
- Blood clots present in grafts or catheters, like central venous catheters (a catheter is placed into a large vein above the heart), bypass grafts (a procedure done to improve the blood flow to the heart), and dialysis catheters (a catheter used to exchange blood to and from a patient and a hemodialysis machine). ( Know more about- What is Dialysis? )
- Heart attack is caused by a blood clot getting lodged in the artery supplying the heart muscle. It results in the death of the heart muscle due to a lack of oxygen. ( Know more about- What is Heart Attack? )
- Blood clots are present in the peripheral arteries, which are the arteries supplying the legs and arms with blood.
- Deep vein thrombosis, which occurs due to the development of a blood clot in a vein in the pelvic region (region below the stomach) or leg. ( Know more about- Deep Vein Thrombosis )
- The deep vein thrombosis blood clot can break off and travel through the body, leading to the blockage of a lung artery (known as pulmonary embolism).
- Ischemic stroke, which is a condition that develops when a blood clot develops and lodges in a brain artery.
What are the contraindications of Thrombolysis?
Thrombolytics are usually not given in the following conditions:
- Bleeding disorders
- Bleeding ulcers
- A recent injury of the head
- Pregnancy
- A recent surgery ( Know more about- What is Heart Bypass Surgery? )
- Trauma
- Uncontrolled hypertension (high blood pressure)
- Taking blood-thinning medications
What is the diagnostic procedure before Thrombolysis?
- Physical examination: A thrombolysis is indicated if the patient shows symptoms of shock, like pale skin, cold skin, bluish tinge to fingernails or lips, rapid breathing, rapid pulse, enlarged pupils, weakness, nausea, and vomiting.
- Angiography: An angiogram is a special x-ray taken by injecting a special dye through a thin, flexible tube, known as a catheter, to detect the presence of blockages or aneurysms (bulging of the blood vessel walls) in the blood vessels. ( Know more about- What is Coronary Angiography? )
- Computerized tomography (CT) scan: X-rays are used to obtain three-dimensional images of the heart and blood vessels.
- Magnetic resonance imaging (MRI) scan: A combination of radio waves, magnets, and a computer is used to create pictures of the heart and blood vessels.
- Echocardiogram: High-frequency sound waves are used to obtain images of the heart. ( Know more about- What is Echocardiography? )
- Carotid duplex ultrasound: The blood flow in the arteries supplying blood to the brain is assessed using a combination of traditional ultrasound and Doppler ultrasound.
How to prepare for Thrombolysis?
- In case of emergency thrombolysis, you will have no time for preparation.
- In case of a planned thrombolysis, tell your doctor about any herbs, medications, or supplements that you may be taking.
- Your doctor should know if you are suffering from any pre-existing medical diseases.
- If you are sensitive or allergic to any medications, latex, tape, or anesthetic agents, tell your doctor about the same.
- Inform your doctor if there is any possibility of a pregnancy.
- You may be asked to stop taking blood-thinners like warfarin and aspirin a few days before the procedure.
- Follow the instructions given by your doctor about what you can eat, drink, and the medications that you can or cannot take before the procedure.
What is the procedure of Thrombolysis?
- How the doctor performs thrombolysis depends on the type of blood clot you have and whether you have an emergency.
- You will be dressed in a patient gown and lie on the procedure table.
- The doctor will insert an IV.
- A clot-busting medication is given through the IV for IV thrombolysis. The medication travels to the site of the clot and dissolves it.
- In case of catheter-based thrombolysis, the doctor will clean and shave the area on the groin and the area is covered with sterile drapes. Sometimes, an elbow may be used as the site for the procedure.
- Painless electrodes are placed on the chest and attached to the electrocardiogram or ECG machine.
- A local anesthesia is used to numb the groin region. Sedative medication may be given to help you in relaxing.
- An incision is made in the groin region. The catheter is then inserted and guided to the site of the blood clot.
- A clot-busting medication injected or special instruments are used to break up the clot after the catheter is in place.
- The catheter, electrodes, and IV line are then removed.
- You will need to lie flat for approximately six hours after the procedure.
How to care after Thrombolysis?
- You may be able to go home on the same day of treatment, in case of intravenous thrombolytic treatment with no other underlying medical condition.
- In the case of a catheter-based thrombolytic treatment, you are likely to stay in the hospital for a couple of days, especially if thrombolysis is a part of the treatment for conditions like a heart attack or stroke.
- The doctor may perform some imaging tests to confirm the dissolution of the blood clot.
- It is normal to have some discomfort at the groin or elbow region following catheter-based thrombolysis.
- The doctor may prescribe some pain-relieving medications to control the pain and discomfort.
- Some people may notice minor bleeding after the procedure. Some bleeding can be noticed in the gums or nose.
- Contact your doctor if you notice any of the following symptoms following a thrombolytic therapy:
- Excessive bleeding
- Back pain
- Blood in urine ( Know more about- What is Blood in Urine ( hematuria ) ? )
- Blood in stools ( Know more about- What is Blood in Stools? )
- Color changes or changes in temperature or sensations in the extremities
- Chest pain
- Fever
- Nausea
- Lightheadedness
- Shortness of breath
- Redness, pain, or swelling around the incision area
- Worsening of pain in the extremities
- The doctor may recommend blood-thinning medications after the procedure.
- If the blood clot has not dissolved completely or recurs again, additional treatment procedures may be required.
What are the risks of Thrombolysis?
The risks associated with thrombolytic therapy include:
- Bleeding in the brain
- High blood pressure (hypertension)
- Low blood pressure
- Kidney damage, especially in people having a kidney disease
- Internal bleeding
- Severe loss of blood
- Bruising at the site of thrombolysis
- Damaged blood vessels
- Increased risk of infection
- Allergic reactions
- Migration of blood clots, causing obstruction of other blood vessels
- Increased risk of bleeding in old people, pregnant women, and people having bleeding disorders
- Heart attack
- Irregular heart rhythms (arrhythmias)
- Stroke
What is the cost of Thrombolysis in India?
The total cost of thrombolysis in India can range from around INR 10,000 to INR 40,000, depending on the type of procedure done. However, many prominent hospital doctors in India specialize in thrombolysis. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of thrombolysis, there will be an additional cost of living in a hotel and the cost of local travel. So, the total cost of thrombolysis in India comes from a total of INR 13,000 to INR 52,000.
We hope that we could answer all your questions regarding thrombolysis through this article.
If you need more information about thrombolysis, you can contact a Cardiologist.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
