A thrombectomy is an effective surgical procedure to treat a type of stroke. The procedure involves inserting a catheter into an artery to access and remove a blood clot. The overall aim is to restore blood flow to an individual’s brain.

An ischemic stroke is the most common type of stroke. It occurs due to a blood clot preventing blood and oxygen from reaching an area of the brain.

Treatment requires emergency care in a specialized hospital unit and focuses on restoring adequate blood flow to the brain. A person has a better chance of survival the quicker they receive treatment.

This article explains how a thrombectomy can treat a stroke. It also provides information about the procedure, recovery, and a person’s outlook after surgery.

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Experts at the National Heart, Lung, and Blood Institute point out that strokes have different causes and effects on the body, meaning they require different treatments.

Treatment for ischemic strokes, which occur due to a blockage of blood flow to the brain, initially involves medication to dissolve blood clots and prevent others from forming. Doctors will administer blood thinners or a tissue plasminogen activator (tPA) injection.

However, tPA may not work in some cases, or the stroke may cause large clots and severe damage to nearby tissues. At this point, a thrombectomy may be necessary to remove a blood clot from a person’s vein or artery.

The American Stroke Association (ASA) recommends the following guidelines for the early management of an acute ischemic stroke:

  • Imaging scans: Healthcare professionals should carry out CT scans and X-rays as quickly as possible to locate the exact position and size of the blood clot in people eligible for the treatment.
  • IV alteplase: A person should receive tPA or IV alteplase, which also dissolves clots, before the thrombectomy and within 4.5 hours of the onset of stroke symptoms.
  • Thrombectomy: Surgery may be necessary for select people with a large blockage in the artery.

Timing

The ASA states that surgeons should perform a thrombectomy within 16 hours of a person experiencing a stroke.

However, surgeons can perform the surgery up to 24 hours after stroke onset in some people. This may be the case for those with a large blockage in the artery who meet specific advanced imaging criteria.

Ideally, a thrombectomy should begin within a 6-hour window from symptom onset.

Overall, treatment for a stroke is time-sensitive and relies on people calling the emergency services as soon as they notice the signs of a stroke, such as facial drooping, arm weakness, or speech difficulties.

The earlier treatment takes place within the recommended time window, the more positive an individual’s recovery and outlook are likely to be.

The procedure will usually follow these steps:

  1. Preparation and medication: The individual changes into a hospital gown and receives IV fluids into their arm.
  2. Anesthetic: Healthcare professionals numb the access site with a local anesthetic so the person does not feel the incision, which surgeons commonly make in the groin, neck, or arm.
  3. Clot removal: A surgeon threads an instrument called a stent retriever through the catheter and guides it to the blockage. After the stent captures the clot, the surgeon will pull the clot backward to remove it.
  4. Stent placement: The surgeon will push through the clot to keep the artery open after clot removal. They will then place the stent.
  5. Closing and cleaning: The surgeon removes the tools and closes the blood vessel. They then stitch or bandage the incision site.

Immediately after surgery, healthcare professionals take a person into a recovery room for monitoring. People will need to stay at the hospital overnight or longer to recover.

Before the procedure, the doctor will explain to an individual what they should expect during and after the thrombectomy.

They will also discuss the potential complications of the procedure and the person’s medical history to determine any potential risks.

After a thrombectomy, a healthcare professional may encourage a person to move around to lower the risk of further blood clots. A doctor will also prescribe a care plan to help an individual recover.

This may include:

  • Medications: A doctor may prescribe blood thinners and thrombolytics, which are clot-dissolving drugs, after surgery. These medications help break up any remaining fragments and may also prevent future clots.
  • Compression socks: A doctor may suggest that a person wears socks or stockings after the procedure. They support good blood flow in the limbs and can help prevent a clot from returning.
  • Movement: Regular exercise can help improve circulation and lower the risk of blood clots.

Research indicates that a thrombectomy can lead to better outcomes and lower mortality rates. However, survival rates after a thrombectomy depend on several factors, including:

  • a person’s overall health
  • the damage caused by the clot
  • the location of the clot

Within 3 months of having the procedure, most people may be able to continue their usual daily activities without assistance.

A thrombectomy can cause potential complications, including:

A stroke is an emergency and requires urgent medical attention. An ischemic stroke, the most common type, develops due to a blockage in the arteries around the brain.

A thrombectomy can treat a stroke by removing blood clots from a vein or artery. This procedure can restore blood flow and help prevent or minimize damage to vital organs and nearby tissue. The earlier a person receives treatment after symptoms start, the better the outcome is likely to be.

An individual should seek urgent medical attention if they develop symptoms such as difficulty breathing, sudden muscle pain or weakness, or problems with speech or vision.