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What is Thrombolytic Therapy?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 19 November 2016
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Thrombolytic therapy is a medical treatment used after many strokes or heart attacks, or other evidence of huge blood clots, to eliminate the clots. This type of therapy is drug-based and certain medicines are either administered intravenously (IV) or may be given through catheterization. The goal is to quickly get rid of any blood clot or thrombus, to restore function to the area that is impacted by it, such as heart, brain or a limb.

Another term for thrombolytic therapy is clot busting, and this is good description of what occurs when this therapy is employed. The focus is on making certain that clots are removed very quickly by breaking them down. Their continued presence can have such profoundly dangerous effects that treatment is required right away. Most people having thrombolytic therapy will have it within two hours of hospital admission.

Doctors have several different medicines they may use to bust a clot and these are often called thrombolytics. The most common of these is called tissue plasminogen activator (tPA). Other medicines might be considered and these would include streptokinase. Some of these, as the names would suggest, are created from bacteria. Each drug used for thrombolytic therapy may work in a slightly different manner, and one may be deemed more appropriate than another depending on circumstances.

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All of these drugs work to dissolve or bust the clot in a way that medicines like aspirin can’t work. Aspirin is commonly recommended to those suffering a heart attack and it can prevent a blood clot from enlarging in size. On its own, it’s not thought effective enough because it still can’t replace thrombolytic therapy. It can’t reduce the size of a clot that is already in place.

There is significant evidence that thrombolytic therapy can increase survival and minimize damage to the heart if people get this therapy soon after a heart attack. As mentioned, many people receive it shortly after hospital admission. Agencies like the American Heart Association recommend its use within 12 hours of heart attack. Greater urgency is needed if a stroke has occurred because damage to the brain can occur so swiftly.

It’s not appropriate to give this therapy in all instances. If people have a hemorrhagic stroke, where a blood vessel in the brain has ruptured, there is extreme risk if thrombolytic therapy is employed. It may increase bleeding and threaten life severely. Even when used appropriately, this therapy can cause excess bleeding and this can be life threatening as well.

Sometimes the reaction to this therapy is hemorrhagic stroke, but this is estimated to occur in only about 1%. About one in four people do have some bleeding while the treatment is underway, usually from mucus membranes like mouth and nose. This should be brought to the attention of physicians.

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