Catheter-directed Thrombolytic Therapy

Catheter-directed Thrombolytic Therapy is a tool we use to deliver drugs to a blood clot in your artery or a vein. This helps open up your blood vessels without surgery.

What happens during catheter-directed thrombolytic therapy?

You will have already discussed the treatment options with the physician doing the procedure. Prior to your procedure, we’ll 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. You may have a Foley catheter (tube) placed into your bladder.

When it’s time to begin, we’ll take you to a special room that is similar to an operating room. We sometimes use general anesthesia, so you may not be aware of the rest of the procedure. However, we often use conscious sedation, or moderate anesthesia. In this case, you’ll remain slightly awake throughout the procedure. We will monitor your pulse, blood pressure, and your breathing throughout the procedure.

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 an interventionalist will apply a local anesthetic so you don’t feel any pain.

Your interventionalist will make a small incision in your arm, groin or upper thigh to insert the catheter. We’ll use an iodine-based contrast material (dye) to make the blood vessels stand out by taking special x-ray pictures and by looking at a special TV monitor (fluoroscopy). Using an x-ray “map” to guide us, we’ll advance the catheter through the blood vessels until it reaches the blood clot. Then, we’ll administer a “clot-busting” medication (thrombolytic agent) through the catheter to break up the clot. It may take several hours for the medication to dissolve the clot. You will likely go to the Intensive Care Unit while the thrombolytic agent continues to work.

At the end of the procedure, your interventionalist 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 interventionalist will review the results of your catheter-directed thrombolytic therapy with your physician so he or she can discuss the next steps with you. You may need further surgery. We may ask you to return so the interventionalist can check how well you have done after your procedure, and to see if you need any other procedures to make you better.