What is a Mechanical Clot Removal (Thrombectomy)?

If you or someone you know has suffered a stroke, you may have heard about a mechanical clot removal procedure called a thrombectomy. But what is a thrombectomy? What kind of patient would benefit from the procedure? And how effective is it? In this blog post, we will explore the answers to these questions.

What is Mechanical Thrombectomy?

A thrombectomy, or mechanical clot removal, is a minimally invasive procedure used to remove a blood clot from inside the arteries of the brain. It is a medical treatment for strokes caused by large blood clots in the brain (ischemic strokes). This procedure has helped revolutionize medical care for patients with large clots in the past decade, with the hope of reducing the stroke effects and deficits that occur as a result.

The thrombectomy procedure involves making a small incision in the femoral artery (in the groin). Then, a catheter is used to reach the brain and remove the clot. Imaging techniques like fluoroscopy are used to guide the instruments and successfully remove the clot.

When Do You Need a Thrombectomy? ?

Mechanical clot removal is needed when a patient has suffered an ischemic stroke and there is a large blood clot blocking the artery–specifically arteries found in the front of the brain (internal carotid or middle cerebral artery). Using CT or MRI findings in conjunction with the physical exam and last known well time helps the physician determine if a patient is a good candidate for thrombectomy This procedure is most effective when performed within six hours of the stroke occurring, although in some cases it may be performed within 24 hours. Other factors that are considered include age, past medical history, medications you are taking

The decision on whether  thrombectomy is needed following a stroke is evolving rapidly with new research. It is a complex subject that will be thoroughly discussed with each individual patient and their medical team.

How Effective is Mechanical Clot Removal?

Studies have shown that mechanical clot removal can be an effective treatment for large clots causing strokes. One of the initial studies studying the effectiveness of mechanical clot removal showed that if the thrombectomy happens within the first 6 hours the rates of disability compared to standard treatment are lower. Further studies have shown that thrombectomy can be beneficial even up to 24 hours after a stroke happens but only for patients who meet certain criteria.  Several studies have shown that patients who underwent thrombectomy had an almost four times higher rate of living independently after a stroke, when compared to those who did not have the thrombectomy.

However, like any stroke treatment, there are no guarantees and the procedure does fail sometimes. Each case is unique, and the decision to move forward with a thrombectomy should be made by you and your medical team after careful consideration.

The jury is still out on if the clot-busting drug tPA should be given to someone more likely to benefit from thrombectomy. We will know more with time.

What are the risks of Mechanical Clot Removal?

As with any surgery, there are risks associated with mechanical clot removal. These include bleeding, infection, stroke (due to re-occlusion of the artery or damage to the brain during the procedure), and death.

However, many of these risks can be minimized by working with an experienced team and following best practices for patient selection. Studies show that the risks of bleeding and other adverse events for patients undergoing thrombectomy are similar to medical treatment alone.

Optimizing Stroke Recovery

Stroke management and recovery are evolving at a fast pace with the hope of minimizing the damaging effects of strokes. If you or someone you know has suffered a stroke, there are many treatments available that can help. Mechanical thrombectomy is just one of these options and it has been shown to improve outcomes with certain patient populations.

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