Best Thrombolysis Treatment in India

Thrombolysis, also called thrombolytic therapy, is used to break or dissolve blood clots. It helps restore and enhance blood flow, and prevents organ and tissue damage. In this treatment, clot-busting medications are given via an IV line or a long catheter directly to the location of the blockage. Additionally, a mechanical device can be attached to the tip lengthy catheter to remove the clot or break it.

Thrombolysis is a standard emergency treatment used to dissolve blood clots that develop in the arteries that supply the heart and brain. Blood clots can cause heart attacks and ischemic strokes, as well as pulmonary artery disease (acute pulmonary embolism).

Types of Thrombolysis

The types of thrombolysis treatment are as follows:

• Systemic thrombolysis: Here, medication is delivered into the bloodstream via an IV line. This is only used as an emergency procedure to treat heart attack, stroke, and PE. 
• Mechanical thrombectomy: A long catheter, equipped with a suction cup or fluid jet, is inserted using ultrasound  guidance to break up or remove blood clots. This procedure can be combined with catheter-directed thrombolysis.
• Catheter-directed thrombolysis: A catheter is used in catheter-directed thrombolysis to guide medication or a device to the location using x-ray imaging. This is a minimally invasive treatment often used to treat DVT and PAD. 

When is Surgery Needed?

A blood clot, also called a thrombus, can cut off blood flow to some parts of the body, causing severe damage. Thrombolytic therapy is needed to treat these blood clots and to prevent damage to body organs. This treatment is needed when:

• A blood clot blocks a major vein or artery
• Other forms of treatment, like blood thinning medication, don't treat blood clothes

Thrombosis treatment is commonly used on patients who have:

• Major blockages in coronary artery
• Blood clothes inside vessels
• Heart attack
• Blood clothes in the lung
• Reduced blood flow to limbs
• Used catheter for a long time
• Ischemic stroke

Who are the Candidates for Thrombosis Surgery?

Patients who are healthy, below the age of 75 and those who do not have any other underlying medical condition can be treated with thrombolysis. 

Who Should Not Consider Thrombosis  Surgery?

Doctors do not recommend thrombolysis to patients at a higher risk of bleeding. The factors include:

• Active bleeding
• Severe bleeding or brain hemorrhage (intracranial hemorrhage)
• Severe hypertension (high blood pressure)
• Brain or spinal surgery
• Kidney disease
• Recent severe brain injury
• Taking blood thinning medications
• Diabetes or low platelet count

Pregnant individuals and the elderly are at a higher risk of complications.

How to Prepare for Thrombosis  Surgery?

The doctor gives directions to prepare for surgery.

• Do not eat or drink anything a few hours before surgery.
• Inform the doctor of allergies and current medications. Do not take medications before surgery.

What Happens During the Procedure

The procedure depends on the type of thrombolytic therapy. 

During systemic thrombolysis:

• The doctor gives a sedative to help the patient relax.
• Then, local anesthesia is used to numb the region for the IV.
• The IV line is inserted into a vein in your arm. 
• The thrombolytic medicine is absorbed into your bloodstream and travels to the site of the blood clot.
• After the procedure, the IV is removed, and a sterile plug is used to seal the wound.

In most cases, the process lasts an hour.

During catheter-directed thrombolysis:

• The doctor administers a sedative to help the patient relax.
• Use local anesthesia and insert a catheter. The doctor then makes a small incision either on the arm, neck, groin or behind the knee. 
• The catheter is inserted through the vein to send the medication to the blood clot.
• Depending on the situation, the doctor may also use a device attached to one end of the catheter to break the blood clot. 
• The catheter is removed after the procedure, and the incision is closed with a sterile plug and dressing.

The procedure is monitored using an x-ray monitor. 

After thrombolytic therapy, the doctor performs imaging tests to check if the blood clot has already been fully removed. The tests include:

• Angiogram
• Echocardiogram
• CT scan
• Venogram

Possible Complications after Thrombolytic Therapy

Thrombolysis is a safe and effective treatment to improve and regulate blood flow and relieve symptoms. Treatment may not be recommended to patients who consume blood thinning medications, certain herbs, or dietary supplements and those who have an increased risk of bleeding. Thrombolysis may cause the following complications:

• Internal stomach or brain bleeding
• Allergic reaction
• Nose, stool, or urine bleeding
• Ventricular arrhythmia
• Bruising or bleeding at the IV or catheter insertion site
• Low blood pressure 
• Kidney damage, particularly in diabetes
• Enlarged tissue (angioedema)
• Blood clots move to a different area of your body.

Taking Care of Yourself after Surgery

The doctor may recommend a few steps to take care of after the treatment. 

They are:

• Take the medication as directed
• Eat healthy and nutritious food
• Do not smoke or drink alcohol

Take rest for a few days after the procedure to heal.

Prognosis after Thrombolysis 

In most cases, thrombolysis treatment successfully dissolves blood clots. However, some patients may be at risk of redeveloping blood clots or blockages in blood vessels. In such cases, the doctor may suggest another minimally invasive surgery to treat blood clots. 

Review 

Reviewed By Dr. Amrita Chakrabarti, Senior Consultant - Hematology, Hemato-Oncology & Bone Marrow Transplant on 4 June 2024.