A thrombectomy is a surgical procedure to remove a thrombus, or blood clot, in an artery. A doctor may use it to treat some strokes. The procedure helps restore blood flow to the brain.

Other names for this procedure include mechanical clot retrieval, mechanical thrombectomy, or endovascular thrombectomy. This procedure involves using a special device to pull or suck out a blood clot. By removing the thrombus, this procedure helps restore blood flow to the brain.

A doctor may recommend this procedure to treat an ischemic stroke, the most common type of stroke. They occur when a blood clot blocks the flow of blood and oxygen to the brain.

A surgeon looking through a glass door-1.Share on Pinterest

A thrombectomy is a medical procedure that uses a special device to remove a thrombus from a blood vessel. A thrombus is the medical term for a blood clot.

A thrombectomy may be a treatment option for a person who experiences an ischemic stroke, which is the most common type of stroke. It occurs when a blood clot obstructs a blood vessel supplying blood to the brain. Ischemic strokes account for roughly 87% of all strokes.

A surgeon can also use this procedure to treat heart attacks and pulmonary embolisms.

A thrombectomy involves using a special clot removal device. One of these types of devices is a stent retriever, or stentriever.

These are medical devices that can physically remove blood clots to help restore blood flow. Many stentrievers typically consist of nitinol, which is a nickel-titanium alloy. Manufacturers use this metal due to its shape memory, elasticity, and biocompatibility.

When treating a stroke, an interventional neuroradiologist or endovascular neurosurgeon typically leads the thrombectomy. This healthcare specialist is a doctor who specializes in blood vessel disorders in the brain and spine.

After identifying a suitable candidate for a thrombectomy, a doctor will sometimes first administer drugs, such as alteplase, to help break down the blood clot.

To perform a thrombectomy, a doctor will then insert a catheter, which is a long, thin tube, into an artery. They can do this under local or general anesthetic.

They will then guide the catheter through the blood vessel until it encounters the thrombus. Once in place, the doctor will then use the stentriever to capture and remove the blood clot. This will then restore typical blood flow.

A thrombectomy procedure will usually take between 1–3 hours.

In most cases, a doctor will administer clot-busting drugs a few hours after the onset of stroke symptoms to break down a blood clot. Also known as thrombolytic therapy, these drugs work by dissolving the blood clot to help restore blood flow.

However, these drugs may not be able to break down larger blood clots. In such cases, a thrombectomy may be necessary.

A thrombectomy is most effective the sooner a medical professional is able to perform it following a stroke. Typically, a doctor will need to perform a thrombectomy within the first 6 hours of a stroke starting. Evidence suggests performing the procedure in this window can reduce the risk of complications, such as brain damage or long-term disability.

The American Heart Association (AHA) and American Stroke Association guidelines note the following criteria for performing a thrombectomy to treat an acute ischemic stroke:

  1. Pre-stroke modified Rankin scale of less than 2
  2. NIH stroke scale score equal or more than 6; Alberta stroke program early CT score equal or more than 6
  3. Start the procedure within 6 hours of symptoms starting
  4. Causative occlusion of the internal carotid artery or the proximal middle cerebral artery (M1)
  5. Age 18 years or older

While thrombectomy will likely be most effective 6 hours after the onset of symptoms, evidence notes that it can still provide benefit 24 hours after the onset of symptoms.

Current guidelines suggest that only 1 in 10 individuals are eligible for a thrombectomy. However, for those who meet the criteria, evidence notes it is a powerful intervention. It can help prevent and reduce long-term disability in those who experience severe strokes and could help treat clots that clot-busting drugs cannot break down.

Of those who undergo the procedure, roughly half will regain independence. Additionally, around half will also benefit through having less disability than those who did not receive a thrombectomy.

However, there is no assurance that everyone will completely recover after a thrombectomy. The severity of damage due to a stroke depends on how long the thrombus obstructed blood flow. As such, the sooner a surgeon performs the procedure, the higher the likelihood of recovery and lesser injury.

As with any procedure, there is a risk of complications. However, the overall potential benefits of a thrombectomy outweigh the possible risks.

Potential risks of the procedure may include:

  • an allergic reaction to the dye that surgeons in the operations
  • in rare cases, the dye may harm kidney function
  • bruising or swelling at the groin where the surgeon inserts the catheter
  • bleeding in the brain
  • reblockage of the artery
  • infection

A thrombectomy is a medical procedure to remove a large blood clot. If a person is a suitable candidate, a doctor may recommend this procedure to treat an ischemic stroke. It can also treat a heart attack and pulmonary embolism.

The procedure involves a surgeon inserting a catheter into a blood vessel in the groin. The catheter will travel to the blood clot, where the surgeon will then use a stentriever. This is a medical device that captures and removes the blood clot to restore typical blood flow. Surgeons can also use other similar thrombectomy devices to remove blood clots in other parts of the body.