Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (778 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Use of infusions of fibrinolytic agents to destroy or dissolve thrombi in blood vessels or bypass grafts.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Fibrinolytic Therapy; Therapeutic Thrombolysis; Therapeutic Thrombolyses; Thrombolyses, Therapeutic; Therapy, Fibrinolytic; Fibrinolytic Therapies; Therapies, Fibrinolytic; Therapy, Thrombolytic.
Where it fits in the MeSH classification
- Broader topics
- Drug Therapy
- Narrower topics
- Hirudin Therapy
- See also
- Thrombectomy; Mechanical Thrombolysis
Related concepts
- Fibrinolytic Agents
Research landscape
PubMed indexes 29,287 records tagged with the MeSH heading “Thrombolytic Therapy” (counts retrieved 2026-10-29). 5,070 of them (17.3%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 8,452 records.
Reviews account for 6,497 records (22.2%) and meta-analyses for 760. Randomized controlled trials number 1,742 (5.9%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 8,366 |
| 2000-2009 | 7,399 |
| 2010-2019 | 8,452 |
| 2020 onward | 5,070 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 6,497 | 22.2% |
| Meta-analyses | 760 | 2.6% |
| Randomized controlled trials | 1,742 | 5.9% |
Method: PubMed query "Thrombolytic Therapy"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in pharmacology
Drug evidence builds in layers: laboratory pharmacology describes how a compound acts, pharmacokinetic studies describe how the body handles it, and randomized trials test whether it helps and what harms it causes. Post-marketing surveillance and observational studies reveal rarer adverse effects but cannot prove causation. This page is educational and is not a recommendation to start, stop or change any medicine; decisions about treatment belong with a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
The role of neutrophils in tPA thrombolysis after stroke: a malicious troublemaker [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Acute ischemic stroke represents a critical, life-threatening condition affecting the central nervous system.
- Closing excerpt
- This review explores the role of neutrophils in tPA-mediated thrombolysis following acute ischemic stroke, examines neutrophil-associated biomarkers, and outlines potential strategies for enhancing tPA efficacy.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (160 words)
Acute ischemic stroke represents a critical, life-threatening condition affecting the central nervous system. Intravenous thrombolysis with tissue plasminogen activator (tPA) remains a cornerstone for achieving vascular recanalization in such patients; however, its therapeutic utility is limited, with only approximately 10% of patients benefiting due to the narrow therapeutic window and significant risk of hemorrhagic transformation. Enhancing the efficacy of tPA thrombolysis is therefore imperative. Neutrophils have been identified as key modulators of thrombolytic outcomes, interacting with tPA post-stroke to influence treatment effectiveness. The binding of tPA to low-density lipoprotein receptor-related protein 1 (LRP-1) on neutrophil surfaces induces degranulation and formation of neutrophil extracellular traps (NETs). Conversely, neutrophils impede the thrombolytic action of tPA by obstructing its interaction with fibrin and activating platelets. These findings suggest that targeting neutrophils may hold promise for improving thrombolysis outcomes. This review explores the role of neutrophils in tPA-mediated thrombolysis following acute ischemic stroke, examines neutrophil-associated biomarkers, and outlines potential strategies for enhancing tPA efficacy.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39606238 · DOI · PMC11598929
The Added Benefit of Intra-Arterial Thrombolysis After Successful Recanalization by Endovascular Treatment: A Systematic Review and Meta-Analysis of Randomized-Controlled Clinical Trials [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundDespite successful recanalization following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with large-vessel occlusion (LVO), many patients fail to achieve excellent functional outcomes.
- Closing excerpt
- Trial registrationThe prespecified protocol of the present systematic review and meta-analysis has been registered in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (registration ID: CRD420251035903).
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (276 words)
BackgroundDespite successful recanalization following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with large-vessel occlusion (LVO), many patients fail to achieve excellent functional outcomes. Post-EVT intra-arterial thrombolysis (IAT) has emerged as a potential adjunctive strategy to improve microvascular reperfusion and clinical recovery.MethodsWe conducted a systematic review and meta-analysis of randomized-controlled clinical trials (RCTs) comparing IAT plus best medical therapy (BMT) versus BMT alone in LVO-AIS patients with successful recanalization post-EVT. The primary efficacy outcome was 3-month excellent functional outcome [modified Rankin Scale (mRS)-score: 0-1]. Secondary efficacy outcomes included good functional outcome (mRS-score: 0-2) and reduced disability (mRS-score shift analysis) at 3 months. The primary safety outcome was symptomatic intracranial hemorrhage (sICH); secondary safety outcomes included any-ICH and 3-month all-cause mortality. Subgroup and network meta-analyses were performed evaluating the effects of different thrombolytic agents.ResultsSeven RCTs were included, comprising 1083 patients treated with IAT and 1048 patients treated with BMT alone. IAT was associated with higher likelihood of excellent functional outcome (RR: 1.23; 95% CI: 1.11-1.36; I2 = 0%) and reduced disability at 3 months (common-OR: 1.10; 95% CI: 1.03-1.18; I2 = 0%) compared with BMT alone. Similar rates of 3-month good functional outcome, 3-month mortality, sICH and any-ICH were observed. Although no significant subgroup differences emerged, in the network meta-analysis alteplase ranked highest in efficacy [surface under the cumulative rank curve (SUCRA): 90%], followed by tenecteplase (61%) and urokinase (40%) in achieving 3-month excellent functional outcome.ConclusionsIAT improves excellent functional outcomes without compromising safety in LVO-AIS patients with successful recanalization after EVT.Trial registrationThe prespecified protocol of the present systematic review and meta-analysis has been registered in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (registration ID: CRD420251035903).
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40622116 · DOI · PMC12231048
Adjunctive Thrombolytics After Successful Endovascular Reperfusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials [3]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveThe efficacy and safety of intra-arterial thrombolysis (IAT) as an adjunct to endovascular thrombectomy (EVT) in large vessel occlusion strokes (LVOS) remain uncertain, with recent randomized controlled trials (RCTs) yielding conflicting results.
- Closing excerpt
- ANN NEUROL 2025;98:1299-1314.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (223 words)
ObjectiveThe efficacy and safety of intra-arterial thrombolysis (IAT) as an adjunct to endovascular thrombectomy (EVT) in large vessel occlusion strokes (LVOS) remain uncertain, with recent randomized controlled trials (RCTs) yielding conflicting results. This meta-analysis aimed to assess the impact of IAT following successful EVT in patients with LVOS.MethodsA comprehensive search was conducted across PubMed, ClinicalTrials.gov, the Cochrane Library databases, and the International Stroke Conference 2025 abstracts to identify RCTs evaluating IAT following successful EVT from January 2015 to February 2025. The primary outcome was the odds of achieving an excellent functional outcome (defined as a modified Rankin Scale [mRS] = 0-1 at 90 days). Secondary outcomes included 90-day functional independence (mRS = 0-2). Safety measures included symptomatic intracranial hemorrhage (sICH), and mortality at 90 days. The protocol was registered in PROSPERO (CRD420250651602).ResultsThe primary pooled analysis of 6 RCTs (N = 1,974) showed that IAT significantly increased the likelihood of achieving excellent functional outcome at 90 days (mRS = 0-1: odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.21-1.80, p InterpretationIAT following successful EVT significantly enhances the likelihood of achieving an excellent functional outcome, particularly in anterior circulation strokes. Although the benefit in posterior circulation strokes remains uncertain, the lack of significant differences in sICH risk and mortality across thrombolytic drugs and stroke locations support the safety of IAT. ANN NEUROL 2025;98:1299-1314.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40799167 · DOI · PMC12682943
Targeting Neutrophil Extracellular Traps: A New Strategy for the Treatment of Acute Ischemic Stroke Based on Thrombolysis Resistance [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Acute ischemic stroke (AIS) is a life-threatening thrombotic disorder, with intravenous thrombolysis (IVT) serving as the first-line treatment during its acute phase.
- Closing excerpt
- In this review, we summarize current knowledge on the mechanisms by which NETs contribute to thrombosis and thrombolysis resistance, explore the prospective and feasibility of targeting NETs to improve thrombolysis, providing information about the creation of innovative thrombolytic treatment approaches for AIS.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (119 words)
Acute ischemic stroke (AIS) is a life-threatening thrombotic disorder, with intravenous thrombolysis (IVT) serving as the first-line treatment during its acute phase. However, thrombolysis resistance diminishes the success rate of early reperfusion. Recent studies have highlighted neutrophil extracellular traps (NETs) as a critical factor contributing to thrombolysis resistance. Targeting NETs with deoxyribonuclease I (DNase I) has been shown to significantly improve the thrombolytic efficacy of recombinant tissue plasminogen activator (rt-PA) and reduce the risk of hemorrhagic transformation. In this review, we summarize current knowledge on the mechanisms by which NETs contribute to thrombosis and thrombolysis resistance, explore the prospective and feasibility of targeting NETs to improve thrombolysis, providing information about the creation of innovative thrombolytic treatment approaches for AIS.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40461018 · DOI · PMC12799313
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis [5]
- Research article Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis [6]
- Research article Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data [7]
- Research article Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis [8]
- Research article Incidence and Predictors of Early Recanalization After Intravenous Thrombolysis: A Systematic Review and Meta-Analysis [9]
- Research article Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis [10]
References
- Li Q, Ye J, Li Z, Xiao Q, Tan S, Hu B, et al.. The role of neutrophils in tPA thrombolysis after stroke: a malicious troublemaker. . 2024. PMID 39606238 · DOI · PMC11598929
- Palaiodimou L, Papageorgiou NM, Turc G, Gory B, Theodorou A, Bakola E, et al.. The Added Benefit of Intra-Arterial Thrombolysis After Successful Recanalization by Endovascular Treatment: A Systematic Review and Meta-Analysis of Randomized-Controlled Clinical Trials. . 2025. PMID 40622116 · DOI · PMC12231048
- Doheim MF, Mohammaden MH, Jumah A, Yang Q, Zi W, Chen Y, et al.. Adjunctive Thrombolytics After Successful Endovascular Reperfusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. . 2025. PMID 40799167 · DOI · PMC12682943
- Huang G, Wu H, Lin B, Deng D, Liu Y, Qu J, et al.. Targeting Neutrophil Extracellular Traps: A New Strategy for the Treatment of Acute Ischemic Stroke Based on Thrombolysis Resistance. . 2026. PMID 40461018 · DOI · PMC12799313
- Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, et al.. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA. 2014. PMID 24938564 · DOI
- Marti C, John G, Konstantinides S, Combescure C, Sanchez O, Lankeit M, et al.. Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis. Eur Heart J. 2015. PMID 24917641 · DOI · PMC4352209
- Campbell BCV, Ma H, Ringleb PA, Parsons MW, Churilov L, Bendszus M, et al.. Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. Lancet. 2019. PMID 31128925 · DOI
- O'Donoghue M, Boden WE, Braunwald E, Cannon CP, Clayton TC, de Winter RJ, et al.. Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis. JAMA. 2008. PMID 18594042 · DOI
- Seners P, Turc G, Maïer B, Mas JL, Oppenheim C, Baron JC. Incidence and Predictors of Early Recanalization After Intravenous Thrombolysis: A Systematic Review and Meta-Analysis. Stroke. 2016. PMID 27462117 · DOI
- Mistry EA, Mistry AM, Nakawah MO, Chitale RV, James RF, Volpi JJ, et al.. Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis. Stroke. 2017. PMID 28747462 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
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