Thrombolysis

What you should know

  • Thrombolysis is a procedure where medicine is used to dissolve a thrombus (blood clot). A blood clot is a clump of blood that forms in your blood vessel. Blood clots more commonly form in your heart and the deep veins of your arms and legs. A blood clot that forms in the deep veins of your arms or legs is called deep vein thrombosis (DVT). A blood clot can decrease, or stop the flow of blood in the vessel it forms in. A blood clot can also break loose and travel (called an embolus) to other areas of your body. The blood clot can reach your lungs or brain, and decrease the blood supply to that organ. A blood clot can cause life-threatening conditions, such as a heart attack, pulmonary embolism, or stroke.

  • Conditions, such as blood disorders, obesity, or a family history of blood clots can increase your risk for a blood clot. Being pregnant or taking hormone medicines, such as estrogen, may also increase your risk for a blood clot. Other risk factors are increasing age, smoking, long periods of time without activity, and major surgery or trauma. Thrombolytic medicine can be given through your vein, artery, or both. If you had a stroke, treatment should begin within three hours of the start of your symptoms. For some conditions, treatment should be started within 6 to 24 hours of your symptom onset. For DVTs, your caregiver will give you instruction's about when your treatment should begin. Treatment with thrombolytic medicine can dissolve the blood clot, and help your blood flow through your vessels. Treatment also can help prevent serious medical conditions, and can save your life.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may have an allergic response to the medicines used during your procedure. You may get a skin rash or have swelling of your hands, face, lips, and throat. Swelling in your throat may lead to shortness of breath. The medicines may cause bleeding in, or behind your stomach, and from any open wounds. You can also bleed into your brain. Bleeding caused by thrombolytic medicine can be life-threatening.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Without treatment, a blood clot can cause serious damage in your arms, legs, heart, and brain. Blocked blood flow can lead to tissue death and decreased movement. If the clot travels to your heart, lungs, brain or other body organs, you may die. Ask your caregiver if you have any questions or concerns about your condition, treatment, or care.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Getting Ready

Before your procedure:

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Tell your caregiver if you recently had an injury, surgery, or other procedures. Tell him if you have had any medical conditions, such as a heart attack, stroke, or seizures (convulsions). Also tell your caregiver if you have had any blood in your bowel movements or urine.

  • Tell your caregiver if you know or think you might be pregnant.

  • You may need to have blood tests done before your treatment. Imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be done if you had a stroke. Imaging tests are done to look at your blood vessels, and check for bleeding in your brain. You also may need an angiogram to check the location of the blood clot in your body. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

Treatment

What will happen:

  • When given through an IV in your vein, a small amount of the medicine may be given over one minute. The remaining medicine will then be given over the next hour. When the medicine is given through your artery, a catheter will be inserted under x-ray guidance. The catheter is placed within the area of your blood clot. Thrombolytic medicine is then given through the catheter over a period of time to dissolve the clot. If you have a very large blood clot, your caregiver may give the medicine through your vein first. Once the medicine has been given through your vein, it will then be given through an artery, directly into the clot.

  • During your treatment, your caregivers will monitor your heart rate and blood pressure. Caregivers may also check your neurological (neuro) status often during the procedure. Your neuro status is checked to see how well your brain is working. Caregivers may check your eyes, your memory, and your hand grasp.

After your procedure:

You will be watched closely by your caregivers for any problems. Caregivers will continue to check your neuro status, blood pressure, and will monitor you for signs of bleeding. You may need blood tests to check for any bleeding problems. After 24 hours, you may need a CT scan to check your blood vessels for any signs of bleeding. These tests can help your caregiver plan your care for when you leave the hospital.

Contact a caregiver if

  • You cannot make it to your procedure.

  • You have new or worsening arm or leg pain.

  • You have new or worsening redness, warmth, and swelling in an arm or leg.

Seek Care Immediately if

  • You have sudden shortness of breath, or fast breathing.

  • Your skin turns purple on an area of your legs, hips, or arms.

  • You have any of the following signs of a heart attack:

    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns

    • Discomfort or pain in your back, neck, jaw, stomach, or arm

    • Trouble breathing

    • Nausea or vomiting

    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

  • You have any of the following signs of a stroke:

    • Numbness or drooping on one side of your face

    • Weakness in an arm or leg

    • Confusion or difficulty speaking

    • Dizziness, a severe headache, or vision loss

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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