Know the Facts About Cather-Directed Thrombolysis
Catheter-Directed Thrombolytic Therapy is a minimally invasive endovascular treatment that uses x-ray imaging and a catheter (small tube) to precisely guide the delivery of a clot dissolving medication to the site of the blood clot in the pulmonary artery. As the medication dissolves the blockage, blood flow improves immediately, preventing tissue and organ damage by increasing oxygen delivery.
Who should not have Catheter –Directed Thrombolytic Therapy?
Catheter – Directed Thrombolysis may be contraindicated if you:
- Are at risk for increased bleeding (bleeding ulcers) or active bleeding
- Are pregnant or breastfeeding
- Are currently using oral anticoagulants
- Have had any prior intracranial hemorrhage (brain bleed), brain tumor or head trauma
- Have had a stroke within the past three months
- Have had recent brain or spinal surgery
The Procedure
You will be given medication to keep you comfortable throughout the procedure. Your trained Interventional Radiologist will numb the treatment area and through a puncture in your skin, a thin plastic tube (catheter) is inserted into an artery (typically in your groin or neck). Once inserted, X-ray imaging helps the Interventional Radiologist guide the catheter to the clot's location. To treat the clot with medication, the physician leaves the catheter in place and connects it to a machine that delivers the medication at a precise rate. Clot-dissolving medication is delivered through the catheter over several hours to a few days. It may take up to 48-72 hours for the clot to dissolve (although most clots dissolve within 24 hours). When the procedure is complete, the Interventional Radiologist will remove the catheter and apply pressure to stop any bleeding. Sometimes, the doctor may use a closure device to seal the small hole in the artery.
Barring any condition that would make it unsafe, anticoagulants (blood thinners) are given after the procedure. You may be on these for three-to-six months or longer, if necessary.
Risk Factors & Complications
- Bleeding
- Allergic reaction to the medication or dye
- Kidney damage from the dye
- Damage to the blood vessel
Your practitioner will review possible risk factors and complications with you before you have the procedure. You will be asked to sign a consent form stating that you understand the procedure, the risks and any potential complications.
When to call your provider after the procedure
- Chest pain
- Warmth or drainage from the catheter site or worsening pain
- Swelling at the catheter site
- Recurrence of the initial symptoms
- Nausea or vomiting that continues to worsen
