Highly innovative treatment that helps break up blood clots in the
veins and arteries
Blood clotting is a normal process that helps prevent a person from bleeding too much after an injury. However, blood clots in the veins and arteries can be painful and, in certain cases, even life threatening. These blood clots can block the normal flow of blood to an organ or tissues, or may break off from where they were formed and travel to another part of the body where they then block the blood flow to another organ. If an organ is starved of blood, it can become damaged or die. In the case of blood clots in arteries that lead to the heart attack or brain, these can lead to heart attacks or strokes. Dangerous or problematic blood clots can also form in the arteries of the lungs, in the legs and arms, and in arteries that have previously been repaired or opened using catheters or stents.
Thrombolytic therapy is a treatment that helps break up blood clots in the veins and arteries. Depending on the nature and location of the clot, your Hurley physician may inject clot-dissolving medications directly into a blood vessel. In other cases, your physician may insert a long, thin tube, called a catheter, into the vein and move the tip of the catheter to the location of the clot. At the tip of the catheter are small devices that can either deliver clot-dissolving medications directly to the clot or can break up the clot mechanically.
Generally, thrombolytic therapy is a scheduled procedure. However, in urgent cases (such as sudden strokes or heart attacks), emergency thrombolytic therapy may be necessary. All surgical and medical procedures have some risks associated with them; you should discuss these with your Hurley physician before your procedure.
Before the procedure:
Your Hurley physician will conduct a thorough examination to determine your state of health and to make sure that you can receive thrombolytic therapy safely. Your physician will also conduct blood tests and other tests to identify the nature and location of the blood clot, including an angiogram or an electrocardiogram (EKG or ECG). Tell your Hurley surgeon about any medications you are taking and if you have allergies to particular types of medication. These include both over-the-counter medications available at your local pharmacy or store, such as aspirin, as well as prescription medications, many of which may have effects on the blood’s ability to clot.
As the date of the procedure approaches, be sure to tell your physician if you have any symptoms of a cold or flu, such as runny nose, fever and chills, or have an infection. Your procedure may need to be rescheduled until you are well enough to proceed.
Have nothing to eat or drink for 12 hours prior to the procedure. Your physician will tell you whether you should stop taking any other medications or if you can continue to take the medications as prescribed. Shower the evening before and the morning of the procedure, using an antibacterial soap. Arrange for someone to drive you to and from Hurley Medical Center. Prepare to remain at the hospital for 24 to 48 hours; if the underlying problem requires additional treatment, you may be required to remain in the hospital for several more days. Arrive at Hurley two hours prior to your procedure.
During the procedure:
You may be given mild sedation to help you relax, but in most cases patients remain awake during thrombolytic therapy. Once the area of your body where the procedure will be performed is cleaned and, if necessary, shaved, a large sterile drape is placed over you with a small area cut out where the injection or catheter insertion will occur. Yourphysician will numb your skin with a local anesthetic and then make a small puncture over an artery or vein in your groin, your wrist, or your elbow.
Your physician will usually then inject a dye through the catheter, which, together with x-rays, will create a map of your blood vessels (an angiogram) and pinpoint the location of the clot. Depending on the location and characteristics of the clot, your physician may inject the thrombolytic drugs through an IV line. More often, your physician will guide a longer catheter through your blood vessels to the area of the clot and then inject the drugs near or into it. You will not feel the catheters because your veins do not have nerve endings.
The clot-dissolving process can last for several hours; in the case of severe blockages, it may take several days and a series of treatments to break up the clot. Once the procedure is complete, your physician will monitor your blood’s ability to clot. When the blood can coagulate in a satisfactory manner, the IV or catheter will be removed and you will be asked to lie still for several hours until the risk of bleeding from the site of the IV or catheter insertion has diminished.
The procedure for mechanical thrombolytic therapy is similar, except that the small devices attached to the catheter tip to physically remove or break up the clot can work faster than drugs, often in as little as 30 minutes to an hour. Your physician may also use a combination of medications and mechanical techniques.
After you return to your hospital room, you will be asked to remain in bed during your recovery, and you may be required to hold your arm or leg straight for several hours (if the site of the insertion was in one of your limbs). You will likely receive fluids, antibiotics and pain medication, and you will be observed by hospital staff for signs of complications. Once any bleeding from the access site stops and your vital signs are normal, you may be discharged, unless further treatment is required for other conditions that contributed to the formation of the clot(s). You will be given complete instructions for what to do after discharge.
If you notice any unusual symptoms after or during your procedure, you should tell your physician immediately. These symptoms may include problems with your arm or leg, such as swelling, pain that does not get better or gets worse, a feeling of coldness, or the limb turning blue. Other symptoms you should report include fever, difficulty breathing, and problems such as bleeding, swelling, numbness or pain near the site of the catheter insertion. Tell your physician if you experience nausea, back pain or dizziness, because these symptoms could mean you have internal bleeding.
Your physician may prescribe further treatment and recommend lifestyle changes such as a low-fat diet, stopping smoking, and physical exercise to help you regain your health and prevent future problems. You may be also given blood-thinning drugs or other medication to take regularly, to avoid future clots.