Thrombolytic Therapy (Stroke)
An ischemic stroke occurs when blood flow to the brain is blocked. This is most often due to a blood clot in an artery in the brain or artery leading to the brain. Treatment is needed right away to help dissolve the clot and restore normal blood flow. This can limit damage to brain tissue and improve outcome. With thrombolytic therapy, clot-busting medication (called tPA) is used to dissolve the clot. This sheet explains how the treatment is done.
Before the Treatment
Thrombolytic therapy holds increased risks for patients with certain health problems. For this reason, a detailed health history must be taken to check whether it is safe to have the treatment. Be sure to tell the doctor about any health problems you have. The doctor will also ask whether you’ve had specific problems, such as a prior stroke, head injury, and bleeding in the brain.
Tell the doctor about all medications you take. Be sure to mention if you take blood thinners (anticoagulants). Also mention if you take over-the-counter drugs, herbs, and other supplements.
Certain tests need to be done before the treatment. These include blood tests and imaging tests, such as a CT or MRI scan of the brain.
During the Treatment
The treatment is done using an IV line. This is a small tube that is put in a vein in the hand or arm. Clot-busting medication is sent through the IV line to reach the clot. The medication is delivered continuously for one or more hours. You’ll be monitored closely throughout the treatment.
After the Treatment
Following the treatment, you’ll need to stay in the hospital for several days or longer. More imaging tests will be done to check how well the clot is dissolving. Other tests may also be ordered to help find the cause of the stroke.
Risks and Possible Complications Include:
Bleeding in the brain or elsewhere in the body
Allergic reaction to the clot-busting medication (skin rash, itching, swelling of face or tongue)
Chest pain or pressure
Severe headache
Shortness of breath
Worsening of heart problems
Dizziness or lightheadedness
Nausea and vomiting
Death
Follow-Up
Recovery from a stroke can take several months or longer. Be sure to keep all follow-up appointments with your doctor. These are needed to monitor your health and the progress of your recovery. Other treatments, such as medications, rehabilitation, and surgery, may be needed in the future. Your doctor will discuss these with you as needed.
Call 911 or go to an emergency department (ED) right away if you have any of the following signs of a stroke:
Sudden, unexplained numbness or weakness on one side of the body
Problems seeing, double vision, or blurry vision
Sudden confusion or problems with speech
Sudden dizziness, trouble walking, or problems with balance
Sudden, severe headache