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Mechanical Thrombectomy for Stroke

Definition

Mechanical thrombectomy is a procedure to remove a blood clot.

Reasons for Procedure

Some strokes are caused by a blood clot. These clots can block the flow of blood through an artery. This can damage nearby tissue. Brain tissue dies quickly without a steady flow of blood. Mechanical thrombectomy may be used for large clots and clots that do not respond well to medicine.

Removing the blood clot will allow blood to flow again. This will stop or reduce damage to tissue. The faster the treatment is given, the better the outcomes. The goal is to have surgery within 6 hours from when symptoms start.

Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Blood vessel damage
  • Stroke

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

A stroke is an emergency. Tests will be done to find out what type of stroke is occurring. Blood clots cause ischemic strokes. Care will be started as soon as possible. Medicine called tPA may be started. It will help to break up blood clots.

Anesthesia

The type of anesthesia will depend on where the clot is. The doctor may give:

Description of the Procedure

A small cut is made in a blood vessel in the groin. A tube is passed into the vessel. An x-ray will show the doctor where the tube is in the body. The tube will be guided through large vessels up to the clot. A small wire cage called a stent will be passed to the clot. It will catch the clot and widen the blood vessel. The clot will be removed. Blood flow should improve right away. Medicine may be passed through the tube to the area. It will help break up any other clots or stop more clots from forming. The tube is removed. A bandage is placed over the area.

How Long Will It Take?

Up to 1 hour

Will It Hurt?

The incision site will be sore for the first few days. Medicine and home care help.

Average Hospital Stay

The length of stay will depend on overall health. If you have problems, you will need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may give you pain medicine.

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

It will take a few days to fully heal. Physical activity may need to be limited during this time.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Lightheadedness
  • Sweaty skin
  • Excess bleeding
  • Balance problems
  • Chest or back pain
  • Weakness or numbness on one side of the body
  • Problems speaking clearly
  • Problems breathing

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Heart Association
http://www.heart.org

Society for Vascular Surgery
https://vascular.org

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

Public Health Agency of Canada
https://www.canada.ca

REFERENCES:

Endovascular therapy for acute stroke. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/endovascular-therapy-for-acute-stroke. Accessed July 21, 2021.

Ischemic stroke treatment. American Stroke Association website. Available at: https://www.strokeassociation.org/en/about-stroke/treatment/ischemic-stroke-treatment. Accessed July 21, 2021.

McDermott ML. 2018 AHA/ADA stroke early management guidelines. American College of Cardiology website. Available at: https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2018/01/29/12/45/2018-guidelines-for-the-early-management-of-stroke. Accessed July 21, 2021.

Mechanical thrombectomy using a stent retriever. University of Pittsburgh Medical Center website. Available at: https://www.upmc.com/services/stroke-institute/stroke-treatment/mechanical-thrombectomy. Accessed July 21, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 7/21/2021