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Peripheral Arterial Thrombolysis

If a blood clot forms in an artery in the leg or arm, blood flow to the limb can be blocked. This can cause severe pain and death of tissue in the limb. Peripheral arterial thrombolysis is a procedure to dissolve a blood clot in a leg or arm artery. It brings blood flow back to the leg or arm. The procedure is often done by a specially trained doctor called an interventional radiologist.

Blood vessel with plaque in walls and blood clot blocking channel. Thrombolysis can dissolve a clot that is blocking blood flow.

Before the procedure

Follow any instructions you are given on how to get ready. This includes:

  • Follow any directions you’re given for not eating or drinking before the procedure.

  • Tell the technologist what medicines, herbs, or supplements you take. Also tell the technologist if you are or may be pregnant, or if you are allergic to X-ray dye (contrast medium) or other medicines.

During the procedure

  • An IV (intravenous) line is put into a vein. This is to give you fluid and medicines. You may be given medicine through the IV to help you relax. Medicine will be put on your skin where the procedure is to be done. This will keep you from feeling pain at the insertion site.

  • A very small cut (incision) is made at the insertion site. A thin, flexible tube (catheter) is put through the incision into the artery. The radiologist watches the movement of the catheter on a video monitor.

  • Contrast medium is injected through the catheter into the artery. This helps the artery show clearly on X-ray images. The radiologist uses these images as a guide. He or she moves the catheter to the clot.

  • When the catheter reaches the clot, the radiologist injects medicine into the catheter. The medicine will dissolve the clot. This is done slowly, over a period of a few hours. The catheter is left in place until the clot has dissolved. This can take up to 72 hours.

  • Once the clot has dissolved, you may need to have the artery widened. This will be done with peripheral angioplasty or a stent. Your health care provider can tell you more about these treatments.

  • When the procedure is finished, the catheter is taken out. Pressure is put on the insertion site for 15 minutes to stop bleeding.

After the procedure

  • Your doctor or nurse will tell you how long to lie down and keep the insertion site still.

  • You may stay in the hospital overnight.

  • You may have some pain. This can be controlled with medicine.

  • Drink plenty of fluids to help flush the contrast medium from your system.

  • After you go home, care for the insertion site as directed.

 

Possible risks and complications

  • Bleeding at the insertion site or inside your body

  • Bruising at the insertion site

  • Damage to the artery

  • Problems because of contrast medium. These include allergic reaction or kidney damage.

 

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