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Thrombolytic therapy is used to break up dangerous clots inside your blood vessels. Thrombolytic therapy commonly is used to treat an ischemic stroke or a clot in a blood vessel in your brain. It can also be used to treat clots in:
- A lung artery (a pulmonary embolism)
- The deep veins of your leg (deep vein thrombosis, DVT)
- Your heart, which may cause a heart attack
- An artery elsewhere in your body, such as in an arm or leg artery
- A bypass graft or dialysis catheter that has become blocked
During the procedure
- Initially, you will lie on an X-ray table, and machines will monitor your vital signs
- Your doctor will make a small puncture over an artery or vein in your groin, your wrist or your elbow
- Your physician then will numb your skin with a local anesthetic and then sometimes makes a small cut or puncture to reach the blood vessel below. Although you may be given some mild sedation, you will usually stay awake during the procedure
- Contrast will be injected through the catheter to map your blood vessels with angiography and to locate the clot. As the contrast flows through the blood vessels, X-rays are taken
- Your doctor will deliver the thrombolytic drugs in one of two ways: through a short catheter inserted in a vein (an IV catheter) or through a long catheter guided to the clot through your arteries or veins
- Because you have no nerve endings in your blood vessels, you will not feel the catheters as they move through your body
- Your physician will periodically monitor the X-ray screen to see the clot breaking up. The process may take several hours or up to several days, depending on the severity of the blockage
- When the clot has been dissolved or if it cannot be dissolved further, your doctor will stop the medication
- When the tests used to monitor your blood's coagulation ability are satisfactory, the IV or catheter will be removed
- Pressure will be applied to the access site for 10 to 20 minutes to stop any bleeding
After the procedure
- You will usually stay in bed during your recovery. During this time, your doctor and the hospital staff closely watch you for any complications
- You may receive fluids, antibiotics, or painkillers
- If the catheter was inserted through an artery in your arm or leg, you may have to hold the limb straight for several hours
- When bleeding from the access site stops and your vital signs are normal, you may be discharged
- Before your discharge, your doctor will give you instructions to follow after you return home
- You should drink plenty of water for two days to help flush the contrast dye out of your body
- You can usually shower 24 hours after your procedure, but you should avoid baths for a few days
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If you notice any unusual symptoms after or during your procedure, you should tell your doctor immediately. These symptoms may include:
- Arm or leg pain that lingers or gets worse
- A fever
- Shortness of breath
- An arm or a leg that turns blue, develops swelling or feels cold
- Problems around your access site, such as bleeding, swelling, pain or numbness
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