Thrombolytic therapy refers to the use of medicines that dissolve blood clots by activating the body’s natural fibrinolytic system. These medicines are given intravenously (into a vein) or occasionally intra-arterially (directly into the blocked artery) to restore blood flow through an obstructed vessel.
Thrombolytic agents include alteplase, tenecteplase, reteplase, and streptokinase. They work by activating plasminogen, which converts to plasmin and breaks down the fibrin mesh holding the clot together. In clinical practice, thrombolytic therapy is used for acute ischaemic stroke, STEMI when primary PCI is unavailable within the recommended timeframe, and massive pulmonary embolism causing haemodynamic instability or cardiac arrest.
The main risk is significant bleeding, including potentially fatal intracranial haemorrhage. Strict contraindications include recent surgery, trauma, or bleeding history, which must be checked before treatment is given.
For a comprehensive description of thrombolysis, its indications, contraindications, and use in cardiac arrest, see Thrombolysis.
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