Key facts
- What it treats: significant blood clots — including DVT, acute arterial (limb) clots, pulmonary embolism, and clotted dialysis access or grafts.
- How it works: a catheter delivers clot-dissolving medication directly into the clot, sometimes combined with mechanical clot removal.
- Why direct delivery matters: concentrating the medication at the clot site can reduce the overall dose needed compared with intravenous delivery elsewhere in the body.
- Urgency: often performed urgently, particularly for acute limb ischaemia or extensive clot burden.
Catheter-directed thrombolysis delivers clot-dissolving (thrombolytic) medication directly to a significant blood clot, using a catheter positioned within or immediately adjacent to the clot under image guidance. This targeted approach can be more effective, and can reduce the bleeding risk associated with giving clot-dissolving medication systemically, compared with treating the clot from a distance.
How it works
Under image guidance, a catheter is threaded through the venous or arterial system to reach the site of the clot. A thrombolytic medication is then infused directly at that location, sometimes over a period of hours, breaking down the clot from within. In some cases, this is combined with mechanical thrombectomy — physically removing or fragmenting clot material using specialised catheter devices — to speed up the process.
What it treats
- Deep vein thrombosis (DVT) — particularly extensive or proximal clots, where thrombolysis may reduce the risk of long-term post-thrombotic complications
- Acute limb ischaemia — sudden arterial blockage threatening the viability of a limb
- Pulmonary embolism (PE) — in selected patients with significant clot burden
- Clotted dialysis access or vascular grafts — restoring flow through a blocked access
What to expect
Thrombolysis is generally performed in a hospital setting, often with a period of monitoring in a high-dependency or intensive care environment given the medications involved and the need for close observation. Treatment duration varies depending on the extent and location of the clot, and follow-up imaging is used to confirm the clot has resolved and blood flow is restored.
Common questions
What conditions is thrombolysis used for?
Catheter-directed thrombolysis is used for deep vein thrombosis (DVT), acute limb ischaemia from arterial clots, pulmonary embolism, and clotted dialysis access or other vascular grafts.
How is catheter-directed thrombolysis different from clot-dissolving drugs given intravenously?
Delivering the medication directly into the clot through a catheter concentrates its effect at the site of the blockage, which can reduce the overall dose needed and the associated bleeding risk compared with giving it into a vein elsewhere in the body.
Is thrombolysis an emergency procedure?
It often is, particularly for acute limb ischaemia or extensive DVT/PE, where prompt treatment can prevent tissue damage or more serious complications.
Next step
Need to discuss an urgent case?
For urgent clinical concerns, please contact the treating hospital directly. For general enquiries, get in touch with our rooms.
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