Thrombolysis delivers drugs (thrombolytic agents) directly to a blood clot in the head, neck or spinal cord. At Radiology Associates of Richmond, we perform several endovascular thrombolytic techniques.

  • Intra-arterial thrombolysis delivers clot-busting drugs to the tiny arteries in the brain. This procedure for stroke blockages has largely been replaced by neurothrombectomy.
  • Cerebral venous sinus thrombolysis infuses clot-busting medications into the venous sinuses (veins of the brain), which drain blood from the brain.

What happens during cerebral venous sinus thrombolysis?

You will have already discussed the treatment options with your physician doing the procedure.

Prior to your procedure, we will take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure. We may give you medicines to protect your kidneys, antibiotics to help prevent infection, and anti-nausea medications.

When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We often use general anesthesia, so you may not be aware of the remainder of the procedure. For some patients, we use conscious sedation or mild anesthesia, so you will remain slightly awake.

During the procedure, you’ll lie on your back on a table and we’ll clean the area where the catheter (a thin, hollow tube) will enter your body using a special solution to minimize infection. We’ll place sterile drapes over your body and a neurointerventionalist will apply a local anesthetic so you don’t feel any pain.

Your neurointerventionalist will make a small incision in your groin or neck to insert the catheter all the way to the clot. At that point, we’ll administer the thrombolytic agents. You will most likely go to the intensive care unit where the catheter will remain in place so you can, and may receive treatment for many hours—possibly as long as 2 to 3 days—so that the entire clot is dissolved. At the end of the procedure, your neurointerventionalist will withdraw the catheter and either apply pressure or place a special device in the blood vessel to stop the blood from leaking out. Finally, we’ll put a bandage over the incision.

After your procedure, your neurointerventionalist will review the results of your thrombolysis with you and your physician so he or she can discuss the next steps with you.