Thrombolysis is used in diseases such as myocardial infarction, stroke (ischemic stroke) and massive pulmonary embolism to clear a blocked artery and avoid permanent damage to the perfused tissue (myocardium or brain). A less frequent use is to clear blocked catheters that are used in long-term medical therapy.
These drugs are most effective if administered immediately after it has been determined they are clinically appropriate. The advantage of administration is highest within the first ninety minutes, but may extend up to six hours after the start of symptoms.
Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis.
Thrombolytic therapy is indicated for the treatment of venous thrombosis, peripheral arterial occlusion, and myocardial infarction.
Minimizing the delay between onset of symptoms and administration of the drug increases the likelihood of limiting the infarct: the thrombolyticdrugs that hold the greatest appeal for this application are those with clot or fibrin andlsquo;selectivityandrsquo;.
Although it is clear that thrombolyticdrugs are useful and effective for the acute removal of thrombus from veins, no published series has demonstrated a clinical advantage of this therapy to avoid the long-term complications of postphlebitic syndrome years after the illness.
Thrombolytic therapy is a drug that break ups or dissolves blood clots, which are the main cause of both heart attacks and stroke.
The drug is successful in restoring some blood flow to the heart muscle in approximately 75% of patients, but the resultant blood flow may not be entirely normal.
The decision to administer the drug is based upon the history, physical exam consistent with a significant stroke, and a brain CT scan to exclude bleeding.
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