Thrombectomy Removes Stroke-Causing Blood Clot
An acute ischemic stroke occurs when a blood clot blocks the flow of blood in an artery that feeds the brain. Treatment can include the intravenous clot buster called tissue plasminogen activator (tPA) or a minimally invasive procedure called thrombectomy.
Some patients may not respond to tPA, so thrombectomy is another option to use to remove the clot, explains Gregory Velat, M.D., neurosurgeon. Prior to performing endovascular thrombectomy, a series of CT and/or MRI scans are done to determine the location of the affected artery and whether or not any salvageable brain remains. In some cases, too much brain may have already infarcted which is the death of tissue caused by lack of oxygen to warrant endovascular thrombectomy, as the risk of hemorrhage increases with larger infarctions.
Thrombectomy may be performed using a variety of devices that are accessed through the groin artery into the network of blood vessels that supply the brain. One device includes a small catheter that is placed within the clot through which suction is applied in an attempt to remove the blood clot, Dr. Velat explains. In 2012, retrievable stents were approved by the U.S. Food and Drug Administration. These devices are deployed across the clot and allowed to expand over several minutes to essentially ensnare the clot within the tines of the stent. The stent is then retrieved along with the clot to restore blood flow to the brain. In some cases, clot-dissolving medication can also be injected directly into the affected artery to promote thrombectomy.
Patients are typically admitted to the intensive care unit for several days following endovascular thrombectomy. Dr. Velat says the recovery period varies for each patient and largely depends on the severity of the stroke at the time of treatment, the region and amount of brain affected, and the ability to restore blood flow to the affected brain.
Dr. Velat says patients must meet various clinical criteria prior to undergoing endovascular thrombectomy, which is typically reserved for patients with at least moderate to severe strokes. It is important to remember that time lost is brain lost, so call 911 immediately if you or someone you are with experiences the signs and symptoms of a stroke.
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Gregory Velat, M.D.
Lee Physician Group
9981 S. HealthPark Drive
Fort Myers, FL 33908