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Peripheral Venous Thrombolysis

Outline of human figure showing peripheral veins in legs and arms.

A blood clot that forms in a vein in the leg or arm can block blood flow. This can cause swelling and pain. Sometimes the clot may break off and travel to the lungs (pulmonary embolism). This can be fatal. Peripheral venous thrombolysis is a procedure to dissolve a blood clot in a leg or arm vein. This eases symptoms and prevents pulmonary embolism. The procedure is often done by a specially trained doctor called an interventional radiologist.

Before the procedure

Follow any instructions you are given on how to get ready. These include:

  • Follow any directions you’re given for not eating or drinking before the procedure.

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

During the procedure

  • An IV (intravenous) line is put into a vein. This is to give you fluids and medicines. You are given medicine to help you relax and make you sleepy. Medicine will be put on your skin where the procedure is to be done. This is to keep you from feeling pain at the insertion site.

  • A very small cut (incision) is made at the insertion site. This is often behind the knee. A thin, flexible tube (catheter) is put through the incision into the vein.

  • Contrast medium is injected through the catheter into the vein. This helps the vein show clearly on X-ray images. The radiologist uses these images as a guide. He or she moves the catheter through the vein to the clot.

  • When the catheter reaches the clot, the radiologist sends medicine through the clot. The medicine will dissolve the clot. 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.

  • When the procedure is finished, the catheter is taken out. 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 for a few hours or overnight. Plan to have a friend or relative drive you home. 

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

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

 

Possible risks and complications

  • Bleeding inside your body or at the insertion site

  • Bruising at the insertion site

  • Damage to the vein

  • Problems because of contrast medium. These include allergic reaction or kidney damage.

Online Medical Reviewer: Larson, Kim APRN, FNP
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Online Medical Reviewer: Pierce-Smith, Daphne, RN, MSN, CCRC
Last Review Date: 12/17/2013
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