Thrombolytic medicines, such as streptokinase or
tissue-type plasminogen activator (TPA), can dissolve
blood clots. These medicines may be used to treat
pulmonary embolism in life-threatening situations.
All thrombolytics can cause serious bleeding. Bleeding
inside the brain is a particular danger that can cause a stroke or death. In
general, thrombolytics are used only where the risk of bleeding can be balanced
against the risks of not dissolving the blood clot rapidly. Thrombolytics might be used when you have a large blood clot that is:
Severely blocking blood
Decreasing the heart's ability to pump
Causing very low blood pressure and shock.
These medicines are given through a vein in the hand or arm.
Sometimes it is necessary to insert a catheter and give the medicine
directly into the pulmonary artery. You must be hospitalized to receive
Guyatt GH, et al. (2012). Executive summary: Antithrombotic therapy and prevention of thrombosis, 9th ed.-American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2, Suppl): 7S-47S.
Kearon C, et al. (2012). Antithrombotic therapy for VTE disease. Chest, 141(2, Suppl): e419S-e494S.
Kearon C, et al. (2016). Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest, 149(2): 315-352. DOI: 10.1016/j.chest.2015.11.026. Accessed March 1, 2016.
Weitz JL (2016). Pulmonary embolism. In L Goldman, A Schafer, eds., Goldman-Cecil Medicine, 25th ed., vol. 1, pp. 620-627. Philadelphia: Saunders.
ByHealthwise Staff Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine Martin J. Gabica, MD - Family Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerJeffrey S. Ginsberg, MD - Hematology