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Peripheral Venous Thrombolysis

Outline of human figure showing peripheral veins in legs and arms.

A blood clot that forms in a vein in the leg or arm can block blood flow and cause swelling and pain. In certain cases, the clot may break off and travel to the lungs (pulmonary embolism). This can be fatal. Peripheral venous thrombolysis is a procedure to dissolve a blood clot in a leg or arm vein, relieve symptoms, and prevent pulmonary embolism. The procedure is often done by a specially trained doctor called an interventional radiologist.

Before the Procedure

Follow any instructions you are given on how to prepare, including:

  • Do not eat or drink anything for 6 hours before the procedure.

  • Tell the technologist what medications, herbs, or supplements you take; if you are, or may be, pregnant; or if you are allergic to contrast medium (X-ray dye) or other medications.

During the Procedure

  • An IV (intravenous) line is put into a vein to give you fluids and medications. You are given medication to help you relax and make you sleepy. A local anesthetic is given to keep you from feeling pain where the catheter (thin, flexible, tube) will be inserted.

  • A very small incision is made over the insertion site. (This is often behind the knee.) A catheter is inserted through the incision into the vein.

  • Contrast medium is injected through the catheter into the vein. This helps the vein show clearly on X-ray images. Using these images as a guide, the radiologist moves the catheter through the vein to the clot.

  • When the catheter reaches the clot, medication to dissolve the clot is sent through the catheter. This is done slowly, over a period of a few hours. The catheter is left in place until the clot has dissolved. This can take up to 72 hours.

  • When the procedure is finished, the catheter is removed. Pressure is put on the insertion site for 15 minutes to stop bleeding.

After the Procedure

  • Your doctor or nurse will tell you how long to lie down and keep the insertion site still.

  • You may stay in the hospital for a few hours or overnight. Plan to have a friend or relative drive you home. 

  • Drink plenty of fluids to help flush the contrast medium from your system.

  • After you go home, care for the insertion site as directed.


Potential Risks and Complications

  • Bleeding internally or at the insertion site

  • Bruising at the insertion site

  • Damage to the vein

  • Problems due to contrast medium, including allergic reaction or kidney damage


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