Thrombectomy is a procedure to remove a blood clot from a blood vessel. It can be used for some people who have had a stroke.
Blood clots in the brain can cause ischemic (say "iss-KEE-mick") strokes. Thrombectomy can remove the clot and help blood to flow normally again. This can help limit damage to the brain.
To remove the clot, the doctor uses a thin, flexible tube (catheter) and tiny tools.
A person who is having a stroke may also be given a clot-dissolving medicine called TPA (tissue plasminogen activator) first. Thrombectomy may be recommended after TPA, to restore blood flow.
When a blood clot moves to a blood vessel in the brain, it blocks blood flow to that area. Without blood and the oxygen it carries, that part of the brain starts to die. If blood supply isn't restored, permanent damage usually occurs. This is called a stroke. The body parts controlled by those damaged cells can't work, or function, as they should. This loss of function may be mild or severe. It may be short-term or lifelong.
Treatment with thrombectomy can improve recovery from a stroke, especially if it's given as soon as possible after the stroke happens. Doctors try to use thrombectomy within 6 hours of a stroke. It can limit damage to the brain and loss of body function from a stroke by removing the blood clot. If a blood clot in the brain isn't removed, it's more likely to cause serious damage.
In general, the less damage there is to the brain tissue, the less disability a stroke causes. And with less damage to brain tissue, people are more likely to recover from a stroke.
No treatment can guarantee a full recovery from a stroke. But thrombectomy can improve the chances of having less or no disability after a stroke.
First, the doctor will find out the kind of stroke and where the clot is located. The doctor will do a type of X-ray called a CT scan of the brain. This scan can show if there is bleeding. (If there is bleeding, it may be another kind of stroke that is treated differently.) The doctor may order other tests to find the location of the clot or bleeding, check for the amount of damage in the brain, and check for other conditions that can cause symptoms similar to a stroke.
If the stroke is in one of the large blood vessels in the brain, the doctor may recommend thrombectomy.
For the procedure, the person may get medicine to relax or go into a light sleep. The doctor puts a thin, flexible tube (catheter) into a blood vessel in the groin. During the procedure, the doctor moves the catheter through the blood vessel into the brain.
The catheter may be used to inject a dye into the blood vessel. The dye lets the doctor see a picture of the blood vessel on a video screen during the procedure.
The catheter is also used to remove the clot. This is done with a tiny tool that looks like a wire cage. It fits inside the catheter.
The risks of thrombectomy are mainly related to the procedure itself. Risks include bleeding where the catheter was put in and a tear or sudden closure of a blood vessel.
Doctors are very careful about using thrombectomy. They will make sure it is the right procedure. And after treatment, they watch closely during the recovery.
When the doctor recommends thrombectomy, it's because he or she believes that it offers the best chance of recovery from stroke. But because there are also risks, it is up to you or your loved ones to choose it or not.
Based on your condition, the doctor will explain what other choices you have for treatment. They may include other medicines that stop the clot from getting bigger. With or without thrombectomy, you will have care to help you get better. And you'll have medicine to prevent blood clots and to control symptoms.
Having a stroke can make it hard to make quick and complex decisions. Feeling afraid or anxious can make it even harder to think clearly. The hospital staff understands this. They will explain the choices, answer questions, and help you and your loved ones decide about your treatment.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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Current as of: November 21, 2017
Michael P. Pignone, MD, MPH, FACP - Internal Medicine
& Karin M. Lindholm, DO - Neurology
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