Intravenous thrombolysis involves using a thrombolytic (clot-dissolving) medication to treat an ischemic stroke, which happens when a blood clot blocks blood flow to your brain. The medications are delivered directly to your bloodstream using an intravenous (IV) line and are most effective when given within a few hours of the start of your stroke symptoms.
Although strokes often occur with little or no warning, immediate treatment from the experts at UPMC can improve your chances of recovery. Our team will quickly assess and diagnose your condition, so they can recommend the safest, most effective treatment plan for you.
What Is Intravenous Thrombolysis?
Intravenous thrombolysis involves using a clot-dissolving medication to treat an ischemic stroke, which happens when a blood clot blocks blood flow to your brain. The medications are delivered directly to your bloodstream using an intravenous (IV) line and are most effective when given within a few hours of the start of your stroke symptoms.
Types of intravenous thrombolysis
Several types of medications can be used for intravenous thrombolysis. Your doctor will select the medication that will most effectively treat your symptoms with the lowest risk of complications.
Common clot-busting medications used to treat stroke include:
- Alteplase (tPA) — This is the most common medication used to treat ischemic stroke.
- Tenecteplase (TNKase) — Can effectively dissolve clots with a smaller risk of bleeding.
Conditions we treat with intravenous thrombolysis
Why Would I Need Intravenous Thrombolysis?
If you are having a stroke or another condition that is caused by reduced blood flow due to a blood clot, your doctor may provide emergency treatment using intravenous thrombolytics.
Who’s a candidate for intravenous thrombolysis?
Intravenous thrombolysis is an effective emergency treatment for stroke and other conditions, but it is not right for everyone.
Clot-busting medications can increase your risk of bleeding, so they may not be appropriate for people who:
- Are older.
- Bleed easily.
- Have had a recent surgery.
- Have high blood pressure.
- Take blood-thinning medications.
Alternatives to intravenous thrombolysis
Alternatives to intravenous thrombolysis include:
- Catheter-directed thrombolysis — Also called intra-arterial thrombolysis, this therapy delivers medication directly to the site of the blood clot using a small, thin tube called a catheter.
What Are the Risks and Complications of Intravenous Thrombolysis?
Intravenous thrombolysis increases your risk for bleeding, which could become life-threatening in severe cases.
Other risks of intravenous thrombolysis include:
- Allergic reactions.
- Blockages in other places caused by pieces of the dissolved blood clot.
- Low blood pressure.
What Should I Expect From Intravenous Thrombolysis?
Before: How to prepare for intravenous thrombolysis
Intravenous thrombolysis is only offered in emergencies, so you may not have much time to prepare for your procedure.
Before administering intravenous thrombolysis, your doctor may order tests including:
- Blood tests — Your doctor may order blood work to ensure you are healthy enough for the medication and check for signs of illness or infection.
- CT or MR angiogram — Also known as arteriography or an arteriogram, this test uses x-rays or magnets and a special contrast dye to look for problems with the blood vessels in your brain.
- CT scan — A computed tomography (CT) scan can diagnose stroke or another condition caused by a blood clot.
- Doppler ultrasound — A noninvasive test that uses ultrasound waves to measure blood flow through your arteries and veins.
- Echocardiogram (Echo) — A noninvasive test that uses sound waves to create images of your heart.
- Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart and can help to diagnose abnormal heart rhythms that may cause blood clots.
- MRI — MRI is a diagnostic procedure that combines large magnets, radio frequencies, and a computer to produce detailed images of your brain.
To prepare for the procedure, you should:
- Have any tests that your doctor recommends. For example, your doctor may request a blood test before the procedure to determine how long it takes your blood to clot.
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Tell your doctor if you have any other health conditions. Your care team may need to take certain precautions during your treatment for your safety.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting.
How long does intravenous thrombolysis take?
Intravenous thrombolysis is given through an IV. It takes about an hour to administer the full dose of thrombolytic medication.
During your intravenous thrombolysis
You will receive an IV in your hand or arm. Your care team will administer the clot-busting medication through your IV line. The medication will travel through your bloodstream until it reaches and dissolves your blood clot.
Recovery after intravenous thrombolysis
After your IV infusion is complete, you will be monitored closely for signs of bleeding in the intensive care unit (ICU). Your provider may also order imaging tests to make sure the blood clot is dissolving as expected. Most people who experience no complications after intravenous thrombolysis are discharged from the hospital after a few days.
Your doctor will let you know if you need to take a blood-thinning medication (anticoagulant) after discharge from the hospital to prevent additional blood clots from forming.
When to call your doctor about complications
You should let your doctor know if you have:
- Bleeding.
- Chest pain.
- Fever.
- Nausea or headache that won’t go away.
- Numbness or tingling in your arms or legs.
- Warmth, redness, pain, swelling, drainage, or other signs of infection at your IV site.
What’s the prognosis after intravenous thrombolysis?
Intravenous thrombolysis effectively dissolves blood clots in about 75% of people. However, in some people, the blood clot doesn’t dissolve completely, or another blood clot develops in the future. Your doctor will monitor your condition and let you know if you need follow-up care.
Why Choose UPMC for Intravenous Thrombolysis?
When you choose UPMC for intravenous thrombolysis, you will receive:
- Access to world-class stroke expertise — UPMC is among the world’s best multidisciplinary stroke centers, offering comprehensive care using the latest medications and therapies.
- A full range of treatment options — We offer nonsurgical and minimally invasive stroke care, as well as traditional open surgical procedures, allowing us to effectively treat all types of strokes while reducing your risk of complications.
- Multidisciplinary care — We partner with neurologists, rehabilitation specialists, and other medical experts to provide complete care that optimizes your recovery and quality of life.
By UPMC Editorial Staff. Last reviewed on 2025-10-23.
