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Thrombolytic Therapy Indications

Fibrinolysis in acute thromboembolic emergencies

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Thrombolytic Therapy Indications?

Thrombolytic or fibrinolytic agents activate plasminogen to plasmin and dissolve fresh fibrin clots. They are used in acute thromboembolic emergencies where rapid restoration of perfusion can salvage tissue. Indications include massive pulmonary embolism with shock or persistent hypotension, ST elevation myocardial infarction without timely percutaneous coronary intervention and acute ischemic stroke within established time windows.

Available agents include alteplase, tenecteplase and reteplase which are recombinant tissue plasminogen activators with different dosing and pharmacokinetic profiles. Streptokinase is older and rarely used in modern practice. Selection depends on indication, local availability and contraindication profile.

Major bleeding is the principal hazard, particularly intracranial hemorrhage. Strict selection by absolute and relative contraindications including recent surgery, active bleeding, severe hypertension and recent stroke is essential and treatment must be delivered in a setting capable of resuscitation and rescue interventional therapy.

Symptoms

Therapy modality not a symptom
Bleeding risk including intracranial
Hypotension during infusion sometimes
Allergic reaction with streptokinase historical
Reperfusion arrhythmia in coronary use

Risk Factors

Recent major surgery or trauma
Active internal bleeding
Severe uncontrolled hypertension
Recent intracranial hemorrhage or stroke
Known intracranial neoplasm or aneurysm

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When massive PE causes shock
  • When STEMI cannot reach PCI in time
  • When acute ischemic stroke fits time window
  • When peripheral arterial occlusion is acute

Treatment Methods

01
Alteplase tenecteplase or reteplase selection
02
Strict screening for absolute contraindications
03
Monitor for bleeding and neurological change
04
Catheter directed thrombolysis in selected PE
05
Rescue PCI for failed coronary thrombolysis
06
ICU level monitoring during and after infusion

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.