Name of the Procedure:

Injection, anistreplase, per 30 units (HCPCS Code: J0350)

• Common Names: Anistreplase Injection, Clot-dissolving Injection
• Medical Terms: Thrombolytic Injection, Fibrinolytic Therapy

Summary

Anistreplase injection is a medical treatment used to dissolve blood clots in the body. It is administered intravenously and helps in improving blood flow by breaking down clots that can cause serious conditions such as heart attacks or strokes.

Purpose

• Conditions Addressed: Heart attacks (myocardial infarction), certain types of strokes, deep vein thrombosis, and pulmonary embolism.
• Goals: Quickly dissolve dangerous blood clots to restore normal blood flow, reduce the risk of damage to the heart or brain, and improve patient survival rates in emergency situations.

Indications

• Symptoms/Conditions: Acute heart attack symptoms (e.g., chest pain, shortness of breath), recent stroke symptoms, and severe blockages in blood vessels.
• Patient Criteria: Usually administered to patients within a specific time window after the onset of symptoms (e.g., within 12 hours for heart attacks) and those who have no contraindications for thrombolytic therapy.

Preparation

• Pre-procedure Instructions: Patients may need to fast for a few hours before the injection. Medications could be adjusted, especially those affecting blood clotting.
• Diagnostic Tests: Blood tests, electrocardiogram (EKG), and imaging tests such as a CT scan or MRI to confirm the presence and location of blood clots.

Procedure Description

1. Initial Assessment: Patient is evaluated to confirm the need for anistreplase.
2. Intravenous Access: A healthcare professional inserts an IV line.
3. Medication Administration: Anistreplase is administered through the IV in a controlled dosage.
4. Monitoring: Continuous monitoring of patient’s vital signs and response to the medication.

• Tools/Technology: IV line, monitoring equipment (heart monitor, blood pressure cuff).
• Anesthesia/Sedation: No anesthesia is typically required.

Duration

The injection process itself usually takes about 30 minutes, but patient monitoring may continue for several hours.

Setting

Typically performed in a hospital emergency room or intensive care unit (ICU).

Personnel

• Healthcare Professionals: Emergency medicine physicians, cardiologists, nurses trained in critical care, and sometimes pharmacists.

Risks and Complications

• Common Risks: Bleeding at the injection site, minor bruising.
• Rare Risks: Severe bleeding (internal or external), allergic reactions, stroke, or reperfusion injury.
• Management: Immediate medical intervention, medications to control bleeding, and supportive care.

Benefits

• Expected Benefits: Rapid resolution of blood clots, improved blood flow, prevention of further damage to heart or brain tissue.
• Timeline: Benefits may be realized within minutes to hours after administration.

Recovery

• Post-procedure Care: Monitoring for any signs of complications like bleeding or an allergic reaction. Regular checks on vital signs and blood counts.
• Recovery Time: Varies; some patients may start feeling better almost immediately, while others may require days to weeks.
• Restrictions/Follow-Up: May include activity restrictions, dietary guidelines, and follow-up appointments to assess recovery progress.

Alternatives

• Other Treatment Options: Mechanical clot removal (thrombectomy), other thrombolytic medications, anticoagulants.
• Pros and Cons: Mechanical clot removal is more invasive but can be effective when thrombolytics are contraindicated. Anticoagulants prevent further clotting but do not dissolve existing clots as quickly.

Patient Experience

• During Procedure: Patients may feel a quick prick from the IV insertion and then minimal sensation during the injection. Continuous monitoring and reassurance from healthcare staff.
• After Procedure: Possible temporary side effects like light-headedness or mild bruising at the IV site. Pain management and comfort measures include cold compresses and pain-relief medication as needed.