Thrombolysis
Thrombolysis is the process of breaking up a blood clot using medication so the body can more easily remove it.A rheolytic thrombectomy uses a stream of saline or other solution to break the clot into smaller pieces before being sucked back into a catheter. There are numerous techniques to perform thrombolysis as well as indications for this technology. Vascular surgeons are skilled in the application of both arterial and venous thrombolysis.
One of the most common indications for this procedure is deep vein thrombosis (DVT), especially of the pelvic (iliac) veins. These blood clots have a higher chance of moving and becoming a pulmonary embolus (PE) and should be initially treated with anticoagulation as soon as diagnosed. Subsequently, a wire is placed in a deep leg vein through the clot. At this point, the clot busting medicine is placed. Depending on the technique, the vascular surgeon can slowly drip the medication over a day or alternatively use a rheolytic catheter to suck out the clot. During the treatment the patient stays in the intensive care unit to monitor closely for any bleeding. Most patients require treatment for one to three days depending on the burden of disease and laboratory studies. Patients usually have symptom improvement within a day or less.
Arterial thrombosis, especially of occluded bypasses, is also an excellent indication for thrombolysis. The procedure is similar to that of venous thrombolysis except that instead of canulating a vein, the artery is selected. Usually, the contralateral leg is canulated and a wire, followed by a catheter, is maneuvered into the area of thrombosis. Again, the patient requires monitoring in the intensive care unit to look for bleeding. Once the initial clot has been removed if there is an underlying anatomic cause of the thrombosis it can be treated at the same time.
The outcome of this procedure depends on several factors, including the skill of the vascular surgeon, the quality of thefacilities, and the equipment available. When patients are looking for someone to carry out thrombolysis, they should find an acclaimed vascular surgeon. Dr. Jenna Kazil is a brilliant vascular surgeon in Bradenton, FL, who practices at the Florida Surgical Clinic. Dr. Kazil understands that time is of the essence when it comes to thrombolysis. Anyone looking for a dignified Bradenton vascular surgeon should contact Florida Surgical Clinic for their surgical and vascular needs.
