What you need to know about:

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

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Recovery Period:
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Overview of

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

in Thailand

It is the use of drugs to dissolve blood clots. When used in a timely fashion, thrombolytic therapy will help reduce potential serious or life threatening complications such as death or permanent damage.

Goals of

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Thrombolytic therapy is carried out in order to break down blood clots that have formed in blood vessels. Blood clots that form in the coronary arteries may cause myocardial infarction.

Price of

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Average Cost

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Pros and cons of

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Pros

-Administration is quick and easy

Cons

-Patients may have an increased risk for hemorrhage

How It Works:

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage. It also may involve the use of a long catheter with a mechanical device attached to the tip that either removes the clot or physically breaks it up.

Preparation before

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Pre - treatment

Thrombolysis is usually an emergency treatment. If you are diagnosed with a condition that can be treated with thrombolysis you will be transferred to an intensive care unit for close monitoring of your heart and lung functions.

Recovery after

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

Post - treatment

Most of the time, treatment will reverse or alleviate your symptoms. However, thrombolytic therapy is not always successful and may not dissolve the blood clot, particularly if initiation of treatment was delayed. Other times, even if the clot has dissolved the affected tissues (your heart, brain, lungs or leg) may be permanently damaged due to prolonged restriction of blood flow. After treatment, your vascular surgeon will re-assess your symptoms. Imaging tests (e.g., CT scan, echocardiogram, arteriogram or venogram) may be needed to check for any residual blood clot. Depending on the underlying cause of clot formation your vascular surgeon may suggest further treatment—some kind of minimally invasive procedure (e.g. balloon angioplasty, stenting or open surgery). You will eventually be placed on blood thinners (anticoagulants), which may include heparin and warfarin (Coumadin). Even with successful treatment, the clot may redevelop in the same blood vessel. If so, more aggressive treatment will be needed to address the underlying causes of the blood clot and repair damaged tissues and organs.

Risks & side effects

Thrombolytic therapy can lead to complications in some patients, including:  

-Bleeding 5%

-Intracranial hemorrhage 0.5-1%

-Stroke 1%

-Major non-cerebral bleeding 0.7%

FAQs:

Thrombolytic (fibrinolytic) Therapy in Acute Myocardial Infarction

What is thrombosis and what is a thrombus?

Thrombosis is an important part of the normal hemostatic response that limits hemorrhage caused by microscopic or macroscopic vascular injury. Physiologic thrombosis is counterbalanced by intrinsic antithrombotic properties and fibrinolysis. Under normal conditions, a thrombus is confined to the immediate area of injury and does not obstruct flow to critical areas, unless the blood vessel lumen is already diminished, as it is in atherosclerosis.  Under pathologic conditions, a thrombus can propagate into otherwise normal vessels. A thrombus that has propagated where it is not needed can obstruct flow in critical vessels; it can also obliterate valves and other structures that are essential to normal hemodynamic function

What kinds of patients will need thrombolytic therapy?

Thrombolytic therapy may be indicated in patients who have:  

-Blocked arteries of the brain (stroke).  

-Blocked arteries of the heart (heart attack).  

-Blocked arteries of the lung (pulmonary embolism).  

-Blocked veins of the leg (deep vein thrombosis/DVT).  

-Blocked arteries of the leg (acute arterial thrombosis /leg ischemia).  

-Blocked surgical bypasses, blocked dialysis fistulas or catheters.

What is the prognosis after thrombolytic therapy?

Although thrombolysis is usually successful, the treatment is not able to dissolve the blood clot in up to 25% of patients. Another 12% of patients subsequently redevelop the clot or blockage in the blood vessel.  In addition, thrombolysis alone -- even when successful -- cannot treat tissue that has already been damaged by compromised blood circulation. So, further treatment may be needed to address the underlying causes of the blood clot and repair damaged tissues and organs.

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