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Peripheral Arterial Thrombolysis

If a blood clot forms in an artery in the leg or arm, blood flow to the limb can be blocked, resulting in severe pain and death of tissue in the limb. Peripheral arterial thrombolysis is a procedure to dissolve a blood clot in a leg or arm artery and to restore blood flow. The procedure is often done by a specially trained doctor called an interventional radiologist.

Blood vessel with plaque in walls and blood clot blocking channel. Thrombolysis can dissolve a clot that is blocking blood flow.

Before the Procedure

Follow any instructions you are given on how to prepare, including:

  • Do not eat or drink anything for 6 hours before the procedure.

  • Tell the technologist what medications, herbs, or supplements you take; if you are, or may be, pregnant; or if you are allergic to contrast medium (X-ray dye) or other medications.

During the Procedure

  • An IV (intravenous) line is put into a vein to give you fluid and medications. You may be given medication through the IV to help you relax. A local anesthetic is given to keep you from feeling pain where the catheter (thin, flexible tube) will be inserted.

  • A very small incision is made over the insertion site. The catheter is inserted through the incision into the artery. The movement of the catheter is watched on a video monitor.

  • Contrast medium is injected through the catheter into the artery. This helps the artery show clearly on X-ray images. Using these images as a guide, the radiologist moves the catheter to the clot.

  • When the catheter reaches the clot, medication to dissolve the clot is injected through the catheter. This is done slowly, over a period of a few hours. The catheter is left in place until the clot has dissolved. This can take up to 72 hours.

  • Once the clot has dissolved, any narrowing of the artery may be treated using peripheral angioplasty or a stent. Your doctor can tell you more about these treatments.

  • When the procedure is finished, the catheter is removed. Pressure is put on the insertion site for 15 minutes to stop bleeding.

After the Procedure

  • Your doctor or nurse will tell you how long to lie down and keep the insertion site still.

  • You may stay in the hospital overnight.

  • You may have some pain, which can be controlled with medication. 

  • Drink plenty of fluids to help flush the contrast medium from your system.

  • After you go home, care for the insertion site as directed.

 

Potential Risks and Complications

  • Bleeding at the insertion site or internally

  • Bruising at the insertion site

  • Damage to the artery

  • Problems due to contrast medium, including allergic reaction or kidney damage

Online Medical Reviewer: Fetterman, Anne, RN, BSN
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Last Review Date: 12/17/2013
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