What is thrombolytic therapy?

Thrombolytic therapy, also known as clot-busting therapy or fibrinolytic therapy, is a medical treatment that aims to dissolve blood clots (thrombi) that are blocking blood flow in a blood vessel. It involves the use of medications called thrombolytic agents or fibrinolytic agents. These medications work by breaking down the fibrin strands that hold the clot together, allowing the clot to dissolve and restore blood flow.

Thrombolytic therapy is primarily used to treat acute ischemic stroke, a condition in which a blood clot blocks an artery in the brain, leading to a disruption of blood supply and potential brain damage. It can also be used to treat heart attacks caused by blood clots in the coronary arteries, deep vein thrombosis (DVT), and pulmonary embolism (PE).

The most commonly used thrombolytic agents include:

1. Tissue plasminogen activator (tPA): tPA is the most widely used thrombolytic agent. It works by converting plasminogen, an inactive protein present in the blood, into plasmin, which is an active enzyme that breaks down fibrin.

2. Urokinase: Urokinase is another thrombolytic agent that is derived from human kidney cells. It works by directly activating plasminogen to form plasmin.

3. Streptokinase: Streptokinase is a thrombolytic agent derived from bacteria. It works by activating a cascade of reactions that ultimately lead to the conversion of plasminogen to plasmin.

Thrombolytic therapy is typically administered intravenously (IV) directly into the bloodstream. Once infused, the thrombolytic agent circulates throughout the body and reaches the site of the clot. The time required for the clot to dissolve can vary from minutes to hours.

However, it's important to note that thrombolytic therapy is not without risks. It can lead to serious complications, including bleeding, especially in the brain, and an increased risk of stroke. Therefore, it is crucial that thrombolytic therapy is given under careful medical supervision and only when the potential benefits outweigh the risks.