Thrombolytic therapy uses drugs through an IV line or catheter to stop blood clots. This treatment can lessen damage from a heart attack, pulmonary embolism or stroke. It also treats blood clots related to DVT and PAD. Thrombolytic therapy usually successfully treats blood clots, but you may also need other surgery to treat the underlying cause.
Thrombolytic therapy (also called thrombolysis) is the use of medications to dissolve blood clots. Thrombolysis reduces damage to your body’s organs and tissues when there are clots by improving blood flow.
Healthcare providers may use thrombolytic therapy as an emergency treatment if you have acute obstructions to normal blood flow, such as a heart attack, stroke or blood clots in the lungs (pulmonary embolism). Your provider must start these medications as soon as possible to increase the chance of success. Thrombolytic therapy can also help dissolve blood clots related to deep vein thrombosis (DVT), peripheral arterial disease (PAD) and other conditions.
Healthcare providers give thrombolytic therapy either through an IV or through a long, thin tube (catheter).
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
You may need thrombolytic therapy:
Healthcare providers don’t recommend thrombolytic therapy if you have conditions related to an increased risk of bleeding, such as:
People who are pregnant or elderly also have an increased risk of complications.
Providers may use thrombolytic therapy to treat:
Providers use three types of thrombolysis:
If you have an emergency, such as a heart attack, stroke or PE, your provider will start thrombolytic therapy as soon as possible. For the best outcomes, they aim to start it within:
What happens during thrombolytic therapy depends on whether it’s systemic thrombolysis or catheter-directed thrombolysis.
Your provider will usually deliver systemic thrombolytic therapy through an IV line in an intensive care unit (ICU). Your surgical team:
The procedure usually takes about one hour.
For a scheduled procedure, your provider usually uses catheter-directed thrombolysis. The team:
While the medication is working to break up the blood clot, your team uses X-rays to monitor its progress. They will also check your heart and lungs and watch your blood pressure. It can take up to 48 hours for the clot to dissolve.
After thrombolytic therapy, your healthcare provider will use imaging tests to see if they’ve completely removed the blood clot. They may use the following tests:
Thrombolytic therapy can dissolve blood clots that, if untreated, may cause:
The main risk of thrombolytic therapy is internal bleeding. About 5% of people who have thrombolytic therapy have major bleeds and about 1% have brain bleeds that cause a stroke. Other risks include:
After receiving thrombolytics, you may need to spend:
After you go home, you’ll likely need to take blood-thinning medication to prevent future blood clots from forming.
Your provider may give you medication after the procedure to make sure the clot dissolves. This can take from 12 to 14 hours. They will also put a compression stocking on your arm or leg if the procedure was performed for peripheral occlusion. In cases of pulmonary embolism or heart attacks, stockings are not needed. You’ll probably need to take a blood-thinning medication for three to six months after the procedure.
Thrombolytic therapy usually successfully dissolves blood clots. But up to 25% of people still have a blood clot after thrombolytic therapy. About 12% of people develop a blood clot or blood vessel blockage again. Your provider may also suggest another type of minimally invasive surgery to treat the underlying cause of the blood clot.
Talk to your healthcare provider if you have any of these symptoms after thrombolytic therapy:
A note from Cleveland Clinic
Thrombolytic therapy (thrombolysis) uses drugs (thrombolytics) to get rid of blood clots. Healthcare providers use this treatment for health emergencies such as heart attack, pulmonary embolism and stroke. Thrombolysis also treats blood clots due to deep vein thrombosis or peripheral artery disease. Providers insert an IV line or catheter for thrombolytic therapy. This procedure can take from one hour to 48 hours. Risks of thrombolytic therapy include internal bleeding and low blood pressure. While this treatment most often dissolves blood clots, you may need another surgery to treat the underlying cause.
Last reviewed by a Cleveland Clinic medical professional on 06/16/2022.
Learn more about our editorial process.