Risks of Thrombolysis
Although thrombolysis can safely and effectively improve blood flow and relieve or eliminate symptoms in many patients without the need for more invasive surgery, it's not recommended for everyone. Thrombolysis may not be recommended for patients who use blood-thinning medication, herbs, or dietary supplements, or for people with certain conditions associated with an increased risk of bleeding. These conditions include:
- Severe high blood pressure
- Active bleeding or severe blood loss
- Hemorrhagic stroke from bleeding in the brain
- Severe kidney disease
- Recent surgery
Thrombolysis also may be associated with an increased risk of complications in patients who are pregnant or at an advanced age, and in people with other conditions.
Patients who undergo thrombolysis have a small risk of infection (less than one in 1,000) as well as a slight risk of an allergic reaction to the contrast dye that may be needed for imaging.
Besides risk of serious internal bleeding, other possible risks include:
- Bruising or bleeding at the access site
- Damage to the blood vessel
- Migration of the blood clot to another part of vascular system
- Kidney damage in patients with diabetes or other pre-existing kidney disease
The most serious possible complication is intracranial bleeding, which is potentially fatal. But this complication is rare. Bleeding in the brain that causes stroke occurs in less than 1% of patients.
Prognosis After Thrombolysis
Although thrombolysis is usually successful, the treatment is not able to dissolve the blood clot in up to 25% of patients. Another 12% of patients subsequently redevelop the clot or blockage in the blood vessel.
In addition, thrombolysis alone -- even when successful -- cannot treat tissue that has already been damaged by compromised blood circulation. So further treatment may be needed to address the underlying causes of the blood clot and repair damaged tissues and organs.