Thrombolytic therapy

Thrombolysis is the dissolution of a blood clot.

Thrombolysis occurs physiologically during haemostasis but accelerated thrombolysis is desirable in:

• venous thromboembolic disease
• thrombosis in the following arterial territories:
  • peripheral
  • coronary
  • cerebral

Thrombolytic therapy is routine in the management of peripheral arterial thrombosis and myocardial infarction. Several large trials have confirmed the benefits of thrombolysis in acute stroke within three hours of development of symptoms (1)

Studies have shown that thrombolysis in myocardial infarction is most beneficial when given within 90 min of the onset of symptoms, although a beneficial effects is seen if administration is delayed for up to 12 hr.

Depending on the local circumstances, optimal thrombolysis may require:

• "fast track" treatment for patients admitted to hospital with chest pain
• adequate training for general practitioners in the use of thrombolytics

Reference:

1. Fisher M, Saver JL. Future directions of acute ischaemic stroke therapy. Lancet Neurol. 2015 Jul;14(7):758-67