Blood clots are the main cause of heart attack and stroke. If a blood clot breaks free in your leg (deep vein thrombosis, or DVT) and travels to your lungs, it can cause a pulmonary embolism, blocked blood flow to your lungs.
Thrombolysis uses medications or a minimally invasive procedure to break up blood clots and prevent new clots from forming. Penn Medicine doctors carefully assess the cause of blood clots and then recommend the right medication or procedure to correct clotting problems.
What Is Thrombolytic Therapy?
Thrombolytic therapy can include the use of medications to destroy blood clots or prevent new blood clots from forming. It’s also called fibrinolytic therapy.
Some of these clot-busting drugs are taken by mouth. We may also deliver medications via injection or, more commonly, in a minimally invasive procedure called thrombolysis. We also offer expertise in mechanical thrombolysis, a procedure to remove clots from your blood vessels.
Penn doctors may use thrombolysis to treat blood clots that result from or cause:
Systemic Thrombolysis
Systemic thrombolysis uses thrombolytic drugs and medications that circulate throughout your body to dissolve clots and prevent future blockages. Penn physicians most often use systemic thrombolysis after an emergency such as a heart attack, pulmonary embolism or stroke.
You usually stay in Penn’s specialized cardiac intensive care unit (ICU) while you receive systemic thrombolysis. We deliver the clot-busting thrombolytic drugs through an IV line, a needle inserted in your arm. We closely monitor your breathing and heart function and continually watch for excessive bleeding during your treatment.
Catheter-Directed Thrombolysis
In catheter-directed thrombolysis, Penn surgeons use an endovascular (minimally invasive) approach to reach blood clots and dissolve them. We may use medication or special tools to remove the blood clots.
Your team includes physicians, nurses, technicians and an anesthesiologist (specialist in pain relief). Throughout the procedure, we carefully monitor your well-being to treat the clot and keep you safe.
- You receive anesthesia to keep you comfortable and help you stay still. In most cases, you won’t need general anesthesia to put you to sleep.
- A surgeon makes a tiny incision and inserts a catheter (a long, flexible tube with a camera and small tools) into your blood vessel. The team uses X-ray images to guide the catheter to the clot.
- The team injects dye (contrast medication) to highlight the clot in images. These images help the surgeon decide the best way to treat the clot.
- We may be able to remove the clot using tools on the catheter. This procedure, called mechanical thrombectomy, can remove the entire clot in about an hour. If a narrowed blood vessel is the cause of the clotting, we may use angioplasty and stenting to reopen and support the blood vessel.
- Depending on the clot, we may need to leave the catheter in place to deliver clot-busting medication. A small clot may be dissolved in a few hours. But a severe blockage may take up to 48 hours to remove.
If we can remove the clot, you may not need to stay in the hospital very long after your procedure. If the clot takes longer to break up or you have complications from the clot, you may stay in the hospital for several days.
Thrombolysis (Thrombolytic Therapy): The Penn Medicine Difference
A blood clot in your vein or artery can lead to serious problems. Our vascular surgeons, cardiologists and interventional radiologists have the expertise you need to identify the cause of blood clotting and help get blood flowing again. When you choose the Penn Vascular Surgery and Endovascular Therapy Program, you have access to: