Thrombolysis - Uses

Uses

Diseases where thrombolysis is used:

• Myocardial infarction
• Stroke (ischemic stroke)
• Massive pulmonary embolism
• Acute limb ischaemia

Apart from streptokinase, all thrombolytic drugs are administered together with heparin (unfractionated or low molecular weight heparin), usually for 24–48 hours.

Thrombolysis is usually intravenous. It may also be used during an angiogram (intra-arterial thrombolysis), e.g. when patients present with stroke beyond three hours.

Thrombolysis is performed by many types of medical specialists, including interventional radiologists, vascular surgeons, cardiologists, interventional neuroradiologists, and neurosurgeons. In some settings such as the United States of America, emergency medical technicians may administer thrombolytics for heart attacks in prehospital settings, by on-line medical direction. In countries with more extensive and independent qualifications, prehospital thrombolysis (fibrinolysis) may be initiated by the emergency care practitioner. Emergency Care Practitioners exist, in among other countries, in South Africa, United Kingdom, and New Zealand. Prehospital thrombolysis is always the result of a risk benefit calculation of the heart attack, thrombolysis risks, and PPCI availability. As such, the prehospital practitioner will often consult with the receiving cardiologist as to treatment decisions─ many cardiologists have personal preferences to available treatment options.