Thrombolysis
Learn about thrombolysis in Singapore, a minimally invasive treatment provided by Dr. Manish Taneja from the Supreme Vascular and Interventional Clinic. This treatment uses medication to dissolve blood clots in selected blood vessels. Understand how it works, risks, recovery and treatment options.
Thrombolysis in Singapore
Minimally Invasive Treatment to Restore Blood Flow
Thrombolysis is a treatment used to dissolve blood clots that are blocking blood flow through a blood vessel.
A blood clot can reduce or completely stop circulation to the tissues supplied by the affected vessel. Depending on where the clot occurs, this can cause serious complications and may require urgent treatment.
In selected situations, catheter-directed thrombolysis can deliver clot-dissolving medication directly to or near the blood clot. A thin catheter is guided through the blood vessels to the affected area, allowing medication to be delivered precisely where it is needed.
Thrombolysis may be considered for selected vascular conditions and can sometimes be combined with other endovascular treatments to restore blood flow.
At the Supreme Vascular and Interventional Clinic, vascular treatment is led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
With expertise spanning the brain and body, our specialized clinic provides specialist-led vascular assessment, minimally invasive treatment and continuity of care under one roof.
Treatment Overview
| Treatment Type | Minimally invasive endovascular procedure |
|---|---|
| Also Known As | Catheter-directed thrombolysis, clot-dissolving treatment |
| Used for | Selected blood clots affecting veins or arteries, including DVT, selected pulmonary embolism and acute arterial occlusion |
| Treatment goal | Dissolve or reduce clot burden and restore blood flow |
| How it works | Thrombolytic medication is delivered systemically or directly to the clot through a catheter, depending on the clinical situation |
| Procedure Access | Catheter inserted through the blood vessels |
| Anaesthesia | Depends on the individual procedure and clinical circumstances |
| Follow-Up | Clinical assessment and vascular imaging may be recommended |
| Performed By | Dr. Manish Taneja, dual-trained neurointerventional and peripheral vascular intervention specialist |
What Is Thrombolysis?
Thrombolysis is a treatment that uses medication to dissolve blood clots that are obstructing blood flow.
A blood clot, also called a thrombus, can develop within a blood vessel and partially or completely block circulation. When blood flow is interrupted, the tissues supplied by that vessel may not receive enough oxygen and nutrients. In selected vascular conditions, thrombolysis can be used to break down the clot and restore circulation.
With catheter-directed thrombolysis, a specialist guides a thin catheter through the blood vessels to the location of the clot.
Clot-dissolving medication is then delivered directly to the affected area.
How Does Thrombolysis Work?
Delivering Clot-Dissolving Medication Directly to the Blockage
Before treatment, vascular imaging is used to identify the location and extent of the blood clot. A thin catheter is guided through the blood vessels towards the affected area. Clot-dissolving medication is delivered through the catheter to the blood clot.
The medication gradually breaks down the clot and helps restore blood flow. Imaging is used to monitor the blood vessel and assess the treatment response. Additional treatment may be performed if a remaining narrowing or blockage is identified.
Key Difference: Thrombolysis uses medication to dissolve a blood clot, while mechanical thrombectomy uses a specialised device to physically remove a clot.
When Might Thrombolysis Be Recommended?
Thrombolysis may be considered when a blood clot is significantly restricting blood flow and catheter-directed treatment is appropriate.
Your specialist will consider:
- The location of the clot
- The size and extent of the blockage
- How long the clot has been present
- The severity of the symptoms
- The affected blood vessel
- Your risk of bleeding
- Your medical history
- Other medications you are taking
- Whether another treatment may be more appropriate
Thrombolysis is not suitable for everyone. The potential benefits must be carefully weighed against the risk of bleeding and other complications.
Where Is Thrombolysis Used?
Deep Vein Thrombosis (DVT)
Catheter-directed thrombolysis may be considered for selected patients with extensive or limb-threatening DVT, particularly when rapid restoration of venous flow is important.
Pulmonary Embolism (PE)
Thrombolytic therapy may be considered for selected patients with acute pulmonary embolism, particularly those with haemodynamic instability or deterioration despite anticoagulation.
For selected patients, thrombolytic medication can be delivered systemically or directly into the pulmonary arteries using a catheter. Catheter-directed thrombolysis is designed to deliver the clot-dissolving medication closer to the pulmonary embolus.
Treatment decisions depend on PE severity, haemodynamic status, bleeding risk and the availability of alternative treatments such as catheter-based mechanical thrombectomy or surgical embolectomy.
Acute Arterial Occlusion
Thrombolysis may be used in selected cases of acute arterial occlusion to dissolve clot and restore blood flow, depending on the location and severity of the blockage.
Thrombolysis vs Mechanical Thrombectomy
Understanding the Difference
Both treatments are used to treat blood clots, but they remove the clot in different ways.
| Thrombolysis | Mechanical Thrombectomy |
|---|---|
| Uses medication to dissolve the clot | Uses a specialised device to physically remove the clot |
| Medication is delivered to or near the clot | A catheter-based device captures or removes the clot |
| May take longer for the clot to dissolve | Can provide rapid clot removal in selected cases |
| Useful for selected vascular conditions | Used for selected acute large-vessel blockages |
| Carries medication-related bleeding considerations | Carries procedure-related vascular and bleeding risks |
The appropriate treatment depends on the location and characteristics of the clot, how urgently blood flow needs to be restored and the patient's individual circumstances.
Thrombolysis for Peripheral Arterial Blockages
Restoring Blood Flow to a Limb
Blood clots can sometimes block arteries supplying the legs or other parts of the body.
An arterial clot can cause a sudden reduction in blood flow and may result in symptoms such as:
- Sudden leg pain
- Coldness of the affected limb
- Pale or discoloured skin
- Numbness or tingling
- Weakness
- Reduced or absent pulses
An acute arterial blockage can be a medical emergency. In selected patients, catheter-directed thrombolysis may be considered to dissolve the clot and restore blood flow.
Urgent assessment is important when symptoms suggest an acute loss of circulation.
Potential Benefits of Thrombolysis
Minimally Invasive Treatment for Selected Blood Clots
For appropriately selected patients, thrombolysis may provide several potential benefits.
Targets the Blood Clot
Catheter-directed treatment allows clot-dissolving medication to be delivered close to the blockage.
Can Restore Blood Flow
Reducing the clot burden can help reopen the affected blood vessel.
Minimally Invasive Approach
Treatment is performed through a catheter rather than open vascular surgery.
May Reduce the Need for Open Surgery
In selected situations, dissolving the clot may avoid or reduce the need for surgical clot removal.
Can Be Combined With Other Treatments
Thrombolysis may sometimes be followed by angioplasty, stenting or another endovascular procedure if an underlying narrowing is identified.
It is important to remember: Treatment suitability depends on the individual patient. Thrombolysis is not appropriate for every blood clot, particularly when the risk of bleeding is too high.
What Are the Potential Risks and Limitations?
Understanding the Risks of Thrombolysis
The main risk associated with thrombolysis is bleeding because the medication reduces the body's ability to form blood clots.
Potential risks may include:
- Bleeding at the catheter access site
- Allergic or other reactions to medication
- Reaction to contrast dye
- Incomplete clot dissolution
- Recurrent clot formation
- Need for additional treatment
The risk depends on factors including the location of the clot, the medication used, your medical history and your individual bleeding risk.
Your specialist will carefully assess whether the potential benefits outweigh the risks before recommending thrombolysis.
Recovery After Thrombolysis
What Can You Expect After Treatment?
Following thrombolysis, you will be monitored closely because clot-dissolving medication can increase the risk of bleeding.
Monitoring may include:
- Neurological assessment where relevant
- Blood pressure monitoring
- Blood tests
- Assessment of the catheter access site
- Monitoring of the affected limb or organ
- Follow-up vascular imaging
Your recovery depends on the location and severity of the original blockage, how successfully blood flow was restored and your overall health.
Additional treatment may be recommended if an underlying arterial narrowing or other vascular problem is identified.
Your Thrombolysis Treatment Journey
| Step | Stage | Description |
|---|---|---|
| 1 | Urgent Vascular Assessment | Assess your symptoms, medical history and suspected blood vessel blockage. |
| 2 | Vascular Imaging | Identify the location, extent and characteristics of the blood clot. |
| 3 | Treatment Planning | Determine whether catheter-directed thrombolysis is appropriate for you. |
| 4 | Catheter Placement | Guide a thin catheter through the blood vessels towards the clot. |
| 5 | Clot-Dissolving Medication | Deliver specialised medication directly to or near the blood clot. |
| 6 | Blood Flow Assessment | Use imaging to assess clot reduction and restoration of circulation. |
| 7 | Further Treatment & Follow-Up | Treat any remaining blockage and continue specialist monitoring as required. |
Why Choose the Supreme Vascular and Interventional Clinic for Thrombolysis?
Brain-to-Body Vascular Expertise Under One Roof
Blood clots can affect different parts of the vascular system and may require rapid assessment and carefully selected endovascular treatment.
At the Supreme Vascular and Interventional Clinic, care is led by Dr. Manish Taneja, a dual-trained neurointerventional and peripheral vascular intervention specialist.
Brain-to-Body Vascular Expertise
Dr. Manish Taneja's expertise spans neurointerventional and peripheral vascular procedures, supporting comprehensive assessment of vascular conditions.
Minimally Invasive Treatment
Where appropriate, catheter-directed treatment can address selected vascular blockages without open surgery.
Individualised Treatment Planning
The treatment approach is determined by the clot's location, severity, duration and the patient's individual risk factors.
Advanced Vascular Imaging
Detailed imaging helps identify the location of the blockage and assess blood flow before, during and after treatment.
Continuum of Care
From vascular assessment and treatment planning through intervention and follow-up, our clinic provides continuity of specialist care under one roof.
Frequently Asked Questions About Thrombolysis
What is catheter-directed thrombolysis?
Catheter-directed thrombolysis delivers clot-dissolving medication through a thin catheter directly to or near the blood clot.
What types of blood clots can thrombolysis treat?
Thrombolysis may be considered for selected clots affecting blood vessels, depending on their location, size, duration and the patient's individual circumstances.
Is thrombolysis the same as mechanical thrombectomy?
No. Thrombolysis uses medication to dissolve a clot, while mechanical thrombectomy uses a catheter-based device to physically remove the clot.
Is thrombolysis suitable for everyone?
No. The risk of bleeding and other factors must be assessed before thrombolysis is recommended.
How long does thrombolysis take?
Treatment duration varies depending on the location, size and characteristics of the clot and how quickly blood flow responds to treatment.
What happens after thrombolysis?
Patients are monitored for treatment response and potential bleeding, with vascular imaging and additional treatment performed when required.
Can a blood clot return after thrombolysis?
Yes. Further clot formation can occur depending on the underlying condition, so identifying and managing the cause of the clot is important.
Specialist Assessment for Thrombolysis in Singapore
A blood vessel blockage requires prompt assessment to determine its cause, severity and the most appropriate treatment.
At the Supreme Vascular and Interventional Clinic, Dr. Manish Taneja provides specialist vascular assessment, advanced imaging review and personalised treatment planning for patients with vascular blockages and other vascular conditions.
With expertise spanning the brain and the body, our specialized clinic provides minimally invasive vascular and neurointerventional treatment with a continuum of specialist care under one roof.
If you have been diagnosed with a vascular blood clot, referred for thrombolysis or are seeking a specialist vascular assessment, our team can help you understand your condition and the treatment options available.
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