Your Guide to Thrombolytic Therapy (Thrombolysis)

The process of dissolving blood clots using drugs is called thrombolysis. This could be done in the event of an emergency, such as a heart attack, or to treat or avoid complications from diseases that have the potential to produce blood clots.

A potentially life-saving procedure used by medical professionals to dissolve or avoid blood clots is called thrombolysis.

Your body tries to stop bleeding by forming blood clots. However, blood clots can occasionally result in potentially fatal illnesses including renal failure or a heart attack.

This page provides a definition and explanation of thrombolysis. The possible dangers and adverse effects of thrombolysis are also included in the article.

What is thrombolysis?

The term "thrombolytic therapy" (thrombolysis) describes the administration of drugs to break up blood clots. In patients who are at high risk, medical practitioners can also utilise thrombolysis to stop blood clots from forming. Thrombolytic medications are commonly referred to as "clot busters."

Physicians can administer these medications by intravenous (IV), by using a needle in your arm, or by using another body area. With a minimally invasive technique, they can also use a catheter to deliver the medication straight into or close to a blood clot. To put you under anaesthesia for the procedure, you can be given an anaesthetic.

When do doctors recommend thrombolysis?

In emergency conditions, thrombolysis is frequently used by medical experts. For instance, they might give you thrombolytic drugs right away if you have a heart attack or stroke to revive your heart and brain's oxygen and blood flow. Another urgent treatment option for an acute pulmonary embolism is thrombolytic therapy.

If the blood thinners you're taking don't work to prevent or reduce blood clots, your doctor might transfer you to a thrombolytic drug. Additionally, they could advise thrombolysis to treat blood clots that already exist due to ailments like these to prevent emergencies.
  • deep vein thrombosis (DVT)
  • atherosclerosis
  • catheter occlusion
  • peripheral vascular illness (PAD)
  • heart clot caused by blood (intracardiac thrombosis)

What is the procedure for thrombolysis?

Healthcare practitioners can choose from a variety of procedures to provide thrombolytic medicines. A few things to think about are your:
  • a condition that requires treatment
  • age
  • overall health
  • possibility of difficulties, such as severe internal bleeding

Systemic thrombolysis

You could get thrombolytic medications during systemic thrombolysis via an IV line that is connected to a needle in your arm. With the help of this delivery system, the drugs can disintegrate clots throughout your body.

Systemic thrombolysis is usually administered by medical personnel in the event of a medical emergency, such as a heart attack, stroke, or pulmonary embolism.

Catheter-directed thrombolysis

One method that is minimally invasive is catheter-directed thrombolysis. Following the administration of an anaesthetic to induce anaesthesia, the procedure is carried out by medical specialists. They might plan this treatment to address blood clots caused by PAD and DVT.

A tiny hole allows them to introduce a thin, hollow tube known as a catheter into a blood vessel during the surgery.

On the tip of the catheter are instruments and a small camera. A medical practitioner uses X-ray images on a screen to guide it into the clot. Afterwards, thrombolytic drugs are injected straight into the clot via the catheter.

Using the instruments on the catheter, a medical expert may occasionally manually remove the clot. A mechanical thrombectomy is the operation that this component of it is.

The catheter can be left in place to continuously give medication until the clot melts if removal of the clot is not possible. It could take a few hours or two days to complete.

Thrombolysis vs. thrombectomy

Thrombolysis is the process of dissolving blood clots. A thrombus is surgically excised from an artery or vein during a thrombectomy. A thrombectomy can be carried out by a medical practitioner during catheter-directed thrombolysis.

Using a balloon catheter or other mechanical instrument, medical experts can manually remove the blood clot during a mechanical thrombectomy, thereby reestablishing blood flow.

What are common drugs used for thrombolytic therapy?

Thrombolytic medicines belong to a class of pharmaceuticals known as serine proteases. Thrombolytics are also known as fibrinolytic medications by experts.

By dividing and dissolving the proteins (fibrins) that hold blood clots together, these drugs disintegrate them.

There are various kinds of thrombolytic medications available. Their dangers, costs, and efficacy differ. The kind you can obtain and why can be determined with the assistance of a healthcare provider.

Among the thrombolytic drugs that physicians frequently recommend are:
  • alteplase (Activase)
  • anistreplase (Eminase)
  • urokinase (Kinlytic)
  • reteplase (Retavase)
  • streptokinase (Streptase)
  • tenecteplase (TNKase)
Prourokinase is a different medication that showed promise in a clinical trial conducted in 2023, but the FDA has not yet approved it.

What are the risks and side effects of thrombolysis?

Thrombolytic therapy's principal risk is internal bleeding, which can include brain bleeds. Additionally, kidney injury might happen, particularly in diabetics.

Additional adverse effects that could occur include:
  • angioedema
  • ventricular arrhythmia
  • low blood pressure
  • blood in stool or urine
  • nosebleeds
  • medication-related allergic response
  • bruises where the catheter or IV was inserted
  • migration of a blood clot to a different area of the body

Who shouldn’t undergo thrombolysis?

In cases when there is a considerable chance of severe bleeding, a medical practitioner might not advise this course of action. Older adults and pregnant women may also be more vulnerable to the procedure's complications.

You may be unable to get thrombolytic therapy if you have any of the following conditions:
  • severe kidney disease
  • past severe brain damage or brain haemorrhages
  • a recent brain or spinal surgery

What is the outlook for people after thrombolysis?

Although thrombolysis is a very successful treatment for blood clots, it may not be suitable for all patients. New blood clots can form in certain individuals even after thrombolysis.

Medical experts usually advise continuing testing, including leg sonograms, to check for the emergence of new clots. Additionally, they might advise continuing to take oral thrombolytics or other drugs that prevent blood clots from forming.

If any of the following blood clot symptoms appear, you can be your own greatest advocate by promptly bringing them to the attention of a medical professional:
  • sharp chest pain
  • shortness of breath
  • coughing up blood
  • a leg or arm that is discoloured or feels heated, swollen, throbbing, or cramping


What is the difference between thrombolysis and thrombolytic therapy?

Thrombolysis, sometimes referred to as thrombolytic therapy, is a medical procedure used to enhance blood flow, eliminate potentially harmful clots in blood vessels, and shield vital organs and tissues from harm.

What is the principle of thrombolytic therapy?

Thrombolytic therapy, sometimes referred to as fibrinolytic therapy, increases blood flow by dissolving potentially harmful intravascular clots to prevent ischemic damage. One important physiological reaction that reduces bleeding from severe or small vascular injuries is thrombosis.

Can thrombolysis be repeated?

A subset of ERS patients may benefit from repeat thrombolysis if they have already had IVT for their index stroke. It is safe to provide repeated IVT to treat pulmonary embolism or myocardial infarction.


Using drugs to break up blood clots is known as thrombolytic therapy or thrombolysis. It is most frequently used as an emergency treatment by medical experts to stop or prevent harm caused by a pulmonary embolism, heart attack, or stroke.

Bleeding or the blood clot moving to another part of the body are the most frequent side effects of thrombolytics. Those who have a history of kidney illness or are at high risk of bleeding should not use thrombolytics.

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