Thrombolytic Therapy | Neurology | Loyola Medicine

Thrombolytic Therapy

Leading-edge Treatment to Limit Stroke Damage

Loyola Medicine has led the way in the latest protocols that push for immediate delivery of thrombolytic therapy during the first 60 minutes after a stroke, also called the “golden hour.” 

About 85 percent of strokes are ischemic, meaning they are caused by blood clots. For patients with this type of stroke, the most beneficial intervention is thrombolysis. During this procedure, a drug is used to break up or dissolve blood clots and restore blood flow, which limits damage to brain tissue. The drug most commonly used for this procedure is tissue plasminogen activator, or tPA.

A patient with acute ischemic stroke should have intravenous tPA promptly, ideally within the first hour after the attack. It still has benefits if administered within 90 minutes of the first symptoms of stroke.

If you or a loved one experiences any signs of a stroke or mini-stroke, call 911 immediately.  Lost time means lost brain tissue. Stroke symptoms include:

  • Difficulty speaking or understanding someone speaking
  • Sudden confusion, dizziness or unsteadiness
  • Sudden loss of vision, particularly in one eye
  • Sudden, severe headache
  • Sudden weakness or numbness of the face, arm or leg, especially on one side of the body

In addition to stroke, thrombolytic therapy can be used to dissolve blood clotting in:

  • Arteries elsewhere in the body
  • Bypass graft or dialysis catheter that has become blocked
  • Deep veins within the legs (deep vein thrombosis, or DVT)
  • Heart blood vessels
  • Lung artery (pulmonary embolism)

Why Choose Loyola for Stroke Care?

Loyola’s Stroke Center has been accredited by The Joint Commission as a comprehensive stroke center. For nine years running, the center has been recognized by the American Stroke Association with its Get with the Guidelines® – Stroke Gold Plus Quality Achievement Award for our commitment and success in implementing a higher standard of stroke care.

Loyola’s compassionate team understands that a stroke can be life-changing not only for the patient, but also for family members. Loyola takes a multidisciplinary approach to patient care and provides support services for patients and families. 

Our neurology and neurosurgery departments are ranked 37th in the nation on U.S. News & World Report’s 2018-2019 Best Hospitals list. As an academic medical center, Loyola provides compassionate, exceptional care to patients and trains future leaders in neurology and neurosurgery. Loyola’s neuro intensive care unit is equipped with continuous EEG and video monitoring and is staffed by certified technologists and trained neurology nurses, who have earned Magnet status.

What to Expect with Thrombolytic Therapy

Your experienced Loyola doctors will decide whether to administer this therapy based upon:

  • CT scan (computed tomography) to ensure that there is no brain hemorrhage 
  • Medical history
  • Physical exam focusing on signs of stroke

At Loyola, thrombolytic therapy is usually performed with a local anesthesia and a mild sedative. Your doctor will create a tiny puncture in a blood vessel and inject contrast dye in order to find the exact location of your blood clot. You will feel a warm sensation while the dye is being injected. 

Next, your doctor will administer the thrombolytic drug with either an IV or a catheter, which will be guided up to the blood clot. This treatment can take several hours. 

Thrombolytic therapy will not be administered if you have any of the following conditions:

  • Bleeding issues
  • Bleeding ulcers
  • Pregnancy
  • Received blood thinners, such as Coumadin
  • Recent head injury
  • Recent surgery
  • Serious liver disease
  • Trauma
  • Untreated, severe high blood pressure

What are the Risks of Thrombolytic Therapy?

Diabetes and other kidney disease patients are at a higher risk if an angiography is needed for some types of stroke. People with blood clotting diseases are also at a higher risk of complications. Other factors that increase your risk include:

  • Advanced age
  • Diabetic retinopathy, a condition of the eyes
  • Endocarditis, which is an infection of the lining of the heart
  • History of internal bleeding
  • Pregnancy
  • Recent injury or surgery
  • Unmanaged high blood pressure

With thrombolytic therapy, you may be at risk for complications including:

  • Bleeding in the access site or elsewhere
  • Gum bleeding
  • Intracranial hemorrhage
  • Low blood pressure
  • Medication allergy
  • Nose bleeding