Thrombolytic therapy is frequently used in the treatment of suspected strokes. Which of the following is a significant complication associated with thrombolytic therapy?
A. Air embolism
B. Cerebral hemorrhage
C. Expansion of the clot
D. Resolution of the clot
Correct Answer: B. Cerebral hemorrhage
Cerebral hemorrhage is a significant risk when treating a stroke victim with thrombolytic therapy intended to dissolve a suspected clot. Success of the treatment demands that it be instituted as soon as possible, often before the cause of stroke has been determined. Bleeding is the most frequent complication of thrombolytic therapy and can occur in a puncture site or spontaneously anywhere inside the body. Intracranial hemorrhage or hemorrhagic stroke is the greatest concern.
Option A: Air embolism is not a concern. Adverse effects of any fibrinolytic agents are almost similar, which include, but are not limited to, bleeding, hypotension, allergic reactions, angioedema, and reperfusion arrhythmias (when used in acute MI). Among all of the fibrinolytic agents, streptokinase is the most antigenic, thus most frequently complicated by allergic reaction and hypotension.
Option C: The end goal of this therapy is to convert plasminogen into plasmin which is accomplished at the location of the thrombus and on the surface of fibrin by the binding of tPA to plasminogen. This binding helps the conversion.
Option D: Thrombolytic therapy does not lead to expansion of the clot, but to resolution, which is the intended effect. Thrombolytic treatment is also known as fibrinolytic or thrombolysis, to dissolve dangerous intravascular clots to prevent ischemic damage by improving blood flow.