Does Thrombolysis Work for Stroke?

Throbolytic therapy or thrombolysis involves the administration of "clot-busting" drugs directly after a stroke to break up the congealed thrombi that are compromising blood flow in the brain.

A stroke occurs when there is low oxygen or low blood flow to an area of the brain, which can result from a blood clot causing a blockage of blood flow (ischemic stroke), a leak in a blood vessel, or a burst blood vessel (hemorrhagic stroke). Blood carries oxygen to the brain, and when blood flow is diminished, part of the brain can become permanently damaged. 

The most common treatment for acute stroke is use of blood thinners. Alteplase (Activase), also referred to as tPA (tissue plasminogen activator) is a “clotbuster” drug used in emergency settings. The process of administering this drug is called thrombolysis. 

Other treatments are invasive and include removing the clot from the blood vessel, which is done through an artery (endovascular treatments). These treatments involve small catheters threaded through the arteries into the brain in the area of the clot. The clot is removed by suction or clot “retrievers.” These treatments are performed by specialized neuro-interventionalist physicians in hospitals that are designated stroke centers. 

Thrombolysis, also called thrombolytic therapy, is usually an emergency treatment used to dissolve blood clots and is commonly used to treat stroke. Alteplase (Activase), also called as tPA (tissue plasminogen activator) is a “clotbuster” drug used in emergency settings.

Thrombolytic agents are usually given through a peripheral intravenous (IV) line in a vein in the arm so the drug can enter the bloodstream and reach the clot. 

For most people, tPA should be administered within 3 hours of the onset of stroke symptoms.  Studies have shown that tPA improves the chances of recovering from a stroke. Patients who receive tPA within 3 hours are: 

• More likely to recover fully 
• Less likely to have disability 
• Less likely to need long-term care in a nursing home