CLOT BUSTING

BLOOD CLOTS ARE ESSENTIAL to save us from bleeding to death, but when they end up in the wrong place – essentially blocking the passage of blood to an area of the body where it’s needed – the area is starved of essential oxygen and nutrients and begins to die. They can be deadly, causing heart attack (where heart muscle dies), stroke (where brain tissue dies), pulmonary embolus (a blood clot in the lungs wherein lung tissue dies) and ischemic limb (a blood clot to a limb).

An exciting development in treatment of these lifethreatening blood clots is thrombolysis, or clot busters. These are medications that dissolve blood clots rapidly, restoring essential blood supply and minimizing permanent damage or death. They can be given systemically, or throughout the body; in some cases, they can be delivered directly to the blood clot, limiting the risk of bleeding. Thrombolytic medications are very powerful and do carry the risk of causing serious bleeding elsewhere, so they are only given in life- or limb-threatening situations. For example, when the medication is given soon after the onset of symptoms. The medication cannot be safely given if someone has had recent surgery or injury that is susceptible to bleeding.

Another developing treatment is thrombectomy – the removal of the blood clot by use of a net or basket or suction within the blood vessel. This has the advantage of directly addressing the problem at its source. But this is an invasive procedure, and there are risks (bleeding, damage to the blood vessel, infection). Again, the benefits must outweigh the risks, which is often the case when life or limb is on the line.