Thrombolytic Therapy for Stroke
The main cause of stroke is blockage of blood supply to the brain due to formation of blood clot. The thrombolytic therapy uses drugs to quickly break the blood clots and dissolve the obstruction to allow blood flow to the brain. This therapy is mainly used for ischemic strokes.
The thrombolytic medications should begin within 3 hours of the first onset of signs and symptoms of stroke. This helps to avoid severe effects of stroke and disability.
Depending on the patients need, the type of drug and treatment procedure is decided. Tissue plasminogen activator (tPA) is the common drug used for this therapy. Other than this, drugs commonly used for thrombolytic therapy are:
The drug therapy is given only if:
- There is no sign of internal bleeding
- Significant symptoms of stroke have appeared
If the individual suffers from any other medical problem, then usually thrombolytic drug therapy is avoided to reduce risk of damages to other body structures.
Procedure of administration of Thrombolytic therapy:
Thrombolytic therapy uses a long catheter to inject clot-breaking drugs. Initially, these catheters are inserted into the blood vessels and are later guided towards the blood clot. This helps in giving medications directly to the clot. Radiologic imaging is used to examine if the clot is dissolving or not. A small clot can dissolve within few hours but severe blockage may take several days.
Mechanical Thrombectomy is another method which may be opted. This method utilizes a small suction cup, high-speed fluid jet, rotating device or ultrasound device to physically break the clot.
Risk of Thrombolytic Therapy:
A common life-threatening risk of thrombolytic therapy is hemorrhage or bleeding. In almost 25% of the patients undergoing this drug therapy, minor bleeding from nose or gums is seen. Only 1% of the patients may have bleeding in the brain. Other comorbidities in which thrombolysis should be avoided:
- High blood pressure
- Severe bleeding
- Kidney disease
- Recent surgery
The thrombolysis is also not recommended if patient uses blood-thinning medications, or any dietary supplements.Authored By : DR. Manish Vaish
Dr Manish Vaish - Neurosurgeon
Neurosurgeon NCR, Delhi
Dr. Yashpal Bundela MS Mch
Dr.Girish Rajpal MS Mch FINR
Dr. Shiwani Jain MD FNB
PDFC (Neuro-anaesthesia and Critical care)
Dr Hrishikesh Chakrabartty
Dr.Praveen Kumar MS Mch
Dr. Manish Marda MD DM