Peripheral Arterial Thrombolysis

Thrombolysis can dissolve a clot that is blocking blood flow.

Peripheral arterial thrombolysis is a procedure to dissolve a blood clot in a leg or arm artery. It brings blood flow back to your leg or arm. If a blood clot forms in an artery in your leg or arm, blood flow to that limb can be blocked. This can cause severe pain and tissue damage in your limb. 

Peripheral arterial thrombolysis is often done by a specialized doctor called an interventional radiologist. This is a doctor who is specially trained and certified by the American Board of Radiology to use minimally invasive image-guided procedures to diagnose and treat diseases. 

Getting ready for your procedure

Tell your healthcare provider if you are:

• Allergic to X-ray dye (contrast medium) or other medicines
• Breastfeeding
• Pregnant or think you may be pregnant

Tell your healthcare provider about:  

• Any recent illnesses
• All your medical conditions
• Any medicines you are taking

You may need to stop taking all or some of these before the test. This includes:

• All prescription medicines
• Herbs, vitamins, and other supplements
• Over-the-counter medicines such as aspirin or ibuprofen
• Street drugs

• Follow any directions you are given for not eating or drinking before the procedure.
• Follow any other instructions from your health care provider.

During your procedure

In general, you can expect the following:

• An intravenous (IV) 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 (sedation). Medicine will be put on your skin where the procedure will 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 your artery. The health care provider watches the catheter’s movement on a screen.
• X-ray dye is injected through the catheter into your artery. This helps the artery be seen clearly on X-ray images. The interventional radiologist uses these images as a guide. He or she moves the catheter to the clot.
• When the catheter reaches the clot, the doctor will either use a device to remove the clot or leave a catheter in the clot to slowly drip a medicine into the clot to dissolve it.  This can take up to 72 hours. 
• Once the clot has dissolved, you may need to have your artery widened. This can be done by inflating a special balloon. This process technique is called peripheral angioplasty. A mesh tube (stent) may also be used to keep the artery from narrowing.
• When the procedure is finished, the catheter is taken out. Pressure is put on the insertion site for 15 minutes to stop bleeding. The doctor may also use a closure device to stop the bleeding at the insertion site.

After your procedure

• Your health care provider will tell you how long you must 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 X-ray dye out of your body.
• After you go home, care for the insertion site as directed.
• Tell your health care provider if you develop a fever or the chills.