Thrombolysis
How is chemical thrombolysis performed?
How is mechanical thrombolysis performed?
Will my child have pain after the procedure?
What can I expect after the catheter is placed?
When does the catheter come out?
What is thrombolysis?
Thrombolysis is the treatment to break up abnormal blood clots that restrict blood flow. Two approaches can be used to treat the clot: chemical and mechanical. Chemical thrombolysis is where a medication, such as TPA or Urokinase, is administered directly into the clot through a catheter to dissolve it. Mechanical thrombolysis involves disrupting the clot by using a mechanical device.
How is chemical thrombolysis performed?
A thin catheter is passed through a small incision into a blood vessel, usually in the knee or arm. Using x-ray guidance, the catheter is maneuvered to the area where the clot has formed. A contrast agent is injected and a series of x-rays are taken to visualize the clot. These images are reviewed by the Interventional Radiologist and a decision is made regarding the best way to treat the clot.
If the clot can be treated by medication, the catheter is left at the clot site and connected to a pump that will deliver the medication at a precise rate. These medications are administered over several hours to several days. The patient will return to Interventional Radiology periodically to have additional contrast agent injected into the catheter to determine whether the chosen treatment is working. Patients receiving this treatment are carefully monitored in the ICU.
How is mechanical thrombolysis performed?
Mechanical thrombolysis involves using various "clot busting" devices to break down the clot and then remove it through the device. Using x-ray guidance, the device is positioned in the vein containing the clot. In this procedure, the device is not retained for several days, it is removed at the completion of the procedure. The procedure is completed in Interventional Radiology and may need to be repeated. In addition to mechanical thrombolysis, the vessel may be opened with a balloon (angioplasty).
Will my child be awake for the procedure?
No. Depending on your child's medical history and the location of the clot , either intravenous sedation or general anesthesia will be used.
What are the risks of thrombolysis?
The risks are:
- Bleeding, local and systemic
- Clot dislodgement (pulmonary emboli)
- Vein perforation
- Infection
- Allergic reaction to contrast
Will my child have pain after the procedure?
Patients may experience local pain or discomfort which is readily controlled by oral or intravenous pain medication.
What can I expect after the catheter is placed?
To avoid disrupting the catheter's precise placement at the clot, your child's movement will be restricted. Your child will make a few trips to IR with his ICU care team so that x-ray images can be taken to determine if the treatment has been successful.
When does the catheter come out?
When the clot is dissolved or no further improvement can be made, the medication is stopped and the catheter is removed. Your child will have to lie quietly for some time after the procedure as we apply pressure to the catheter entry site to prevent bleeding.
If you have additional questions, please call the IR nurse scheduler at 215-590-7000 (press #1 at the first prompt, and press #2 at the second prompt).
Appointments
- 215-590-7000
