What is thrombolysis?
Thrombolysis is an emergency treatment which uses a clot-busting medicine to break up clots in brain blood vessels and restore blood flow. Thrombolysis needs to be given as soon as possible after stroke symptoms begin, to be most effective.
How thrombolysis works
Thrombolysis uses drugs called alteplase or tenecteplase to break up the clot. You are given one of these through a small tube into a vein in your arm.
During this procedure, and for several hours afterwards, the medical team will closely monitor your blood pressure, body temperature, breathing and blood sugar levels to ensure they remain stable.
Who can have thrombolysis?
This treatment is only given in just over one in 10 strokes at present. There are guidelines for who can and cannot have it, to make sure it’s safe and effective.
To have thrombolysis, you need to reach hospital within the time limits for treatment.
This is usually four-and-a-half hours after symptoms begin. In some circumstances, doctors may decide it could still be of benefit beyond four-and-a-half hours.
If you do not know when symptoms began, perhaps because the stroke happened while you were asleep, this may rule out thrombolysis.
Other reasons why thrombolysis cannot be given include:
- Your stroke was due to bleeding in the brain, not a clot.
- Your stroke is very mild or very severe.
- You have a bleeding disorder.
- You have recently had brain surgery.
- You have had another stroke or head injury within the past three months.
- Your current medication is not compatible with the clot-busting medication.
If you’re able to have thrombolysis, your medical team will explain the treatment to you. If you’re unable to give your consent, either because of the effects of your stroke or another reason, the medical team will discuss it with your next of kin or another family member.
Time is critical. If they cannot talk to your family immediately, the medical team will decide based on what they feel is in your best interests.
Benefits of thrombolysis
Thrombolysis can help save more of the brain by allowing blood to return to your brain cells more quickly. Fewer brain cells die and the impact of the stroke can be reduced, lowering the chance of serious disability.
Risks of thrombolysis
Despite its benefits, there is a risk thrombolysis may cause bleeding in the brain or elsewhere in some people.
Doctors carefully balance the risk to the individual patient against the potential benefit of the treatment. So someone may not be eligible for thrombolysis if they have conditions like internal bleeding, an aneurysm, uncontrolled high blood pressure or are taking anticoagulant drugs for atrial fibrillation.
Our Stroke Support Helpline is here for you. Whether you need information, or to chat when times are tough, our friendly team is just a phone call or email away. Call us on 0303 3033 100 or email helpline@stroke.org.uk