Thrombolysis
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Transcript Thrombolysis
Thrombolysis
What is it?
A Procedure that removes or destroys
clots
Preformed in a Angio suit
Many times both a Radiologist and a
Vascular surgeon
Most common reason for during procedure
is {peripheral Arterial Occlusive Disease
Techniques
Introduction of catheter into the Femoral
Artery
Catheter Advanced to the clot site
Different Drugs are administered to the
site
Streptokinase, Urokinase, or rtPA
Techniques
Catheter placement in Femoral Artery
Techniques
Local Low Dose Thrombolysis
Discovered by Dotter in 1974
Less hazardous treatment
More efficient
Pharmaceutical - Streptokinase
Techniques
Local Low-Dose
Unlike other techniques at the time the
dose is reduced to 1/20 the size
Very popular in treating ilio-femoral
Thrombosuses
Techniques
Local Low-Dose
Advantages
Pure drug right to thrombus
Protection of lytic agents from antibodies
and inhibitors
Loading dose not necessary
Shorter infusion time
Less costly
Techniques
Local Low-Dose
Techniques
Urokinase Infusion
This technique is most used for patients
with low risk of tissue infarction
Catheter is placed in the affected artery
Tip is placed 5 to 10mm from clot site
Urokinase is infused at a rate of 60 ml/hr
Patient is brought back to department
every 4 to 8 hours to check Clot Lysis
Techniques
McNamara Infusion
The procedure again uses the placement
of catheters to the clot site
This procedure is specially used for
patients at high risk for Limb or Organ
lose
Much like the Low-Dose technique but,
infusion rate is quadrupled for first 6 hours
Techniques
McNamara Infusion
Once clot shows signs of dissolving then
rate is slowed to that of the Low-Dose
technique
If clot does not show any signs of
breaking down the patients will often be
sent to surgery to have organ or limb
removed
Techniques
Hess
Catheter is advanced to the clot site
Either Streptokinase or Urokinase can be
used
A hand injected method is used
1 to 3 ml is given every 5 minutes
Techniques
Hess
Advantages
Operator is able to view clot breaking
down under fluoroscopy, chase clot as it
moves
Operator has full control of when drug is
administered
Shorter procedure