Know the Facts About Systemic Thrombolysis
Systemic thrombolysis is the administration of a medication designed to break down a blood clot anywhere in your body that is blocking a major artery or vein. This treatment helps reduce damage from a life-threatening pulmonary embolism (a blood clot in your lungs), heart attack or stroke by restoring blood flow. To be effective, the therapy needs to be started as soon as possible. The two different systemic thrombolytic medications are known as tPA (tissue plasminogen activator) and TNK (tenecteplase). These medications are given while you are under close monitoring in the hospital and are usually only given for life-threatening clots. Candidates for systemic thrombolysis must have a recent onset of symptoms, low bleeding risk and a confirmed diagnosis.
Who should not have Systemic Thrombolysis?
Systemic Thrombolysis may be contraindicated if you:
- Have active bleeding
- Had a recent brain bleed
- Had recent brain or spine surgery
- Have severe high blood pressure
- Have severe kidney disease
- Had recent traumatic brain injury
Systemic thrombolytic therapy may be used with extreme caution in people who are pregnant, are elderly or are on blood thinners.
The Procedure
You will be placed in a critical care area of the hospital where there are additional staff to closely monitor you. Before receiving the thrombolytic medication, you will be placed on a heart monitor. A large dose (bolus) of the thrombolytic drug is given through an IV site, followed by a continuous infusion. Your breathing and heart function will be monitored closely throughout the administration of the thrombolytic. After administration, radiographic testing may be done to see if the clot broke has improved. You will remain in the critical care area of the hospital for at least 24 hours.
While hospitalized, you may also be started on a blood thinner that you take either by mouth or an injection. You will continue to take this medication for at least 3-6 months, or in some cases, for life.
Risk Factors and Complications
- Bleeding
- Kidney damage
- Allergic reaction
- Low blood pressure
- Clot embolizes (moves to another part of the body)
When to call your provider after the procedure
- Chest pain
- Bleeding/ drainage at the catheter site
- Recurrence of initial symptoms
- Nausea or headache that keeps getting worse
- Tingling/ numbness in arms or legs
