Catheter Directed Thrombolysis

What Is Catheter Directed Thrombolysis?

There are multiple devices that can be used to remove or dissolve blood clots for PE’s (Pulmonary embolism) which are blood clots in the lungs or DVT’s (Deep Vein Thrombosis) which are blood clots in the legs.

An EKOS procedure is one of the techniques frequently used. A catheter is inserted percutaneously (without open surgery) and positioned directly over the blood clot.

Thrombolytics such as tPA (Tissue Plasminogen Activator) are infused directly to blood clot site and left in place over night or for about 24 hours. The combination of drugs and ultrasonic sound waves help break up or dissolve major blood clots. 

What to Expect

After getting informed consent, an IV will be inserted as well as a foley catheter. This is needed for moderate sedation medications and since EKOS catheter must be left in for up to 24H the foley is left in place since you will not be able to get out of bed to void. The procedure can take up to 2 hours.

When treating blood clots in the lungs, usually the catheters are inserted through your jugular vein in the neck or through the femoral vein in your leg. You can sit up during this procedure. If DVT is suspected, please be prepared to lay prone (on stomach) for the duration of procedure. Once the procedure is completed you will be able to lay on your back. Expect to be NPO (nothing by mouth) the entire time the EKOS catheter is left in place.

Once the catheter is removed the next day, you will be discharged on anticoagulant medications for up to 6 months.

The picture on left shows blood clot area with EKOS catheter (dotted lines) placed directly into blood clot area. The picture on right shows the treated vein after EKOS catheter is removed and treatment is complete.

Call Advanced Heart and Vascular Center of New Mexico to learn more.