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Definition

A 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 lead to severe damage to nearby tissue. Brain tissue dies quickly without a steady flow of blood. Medicine may be tried first to break up the clot. Mechanical thrombectomy may be used for clots that do not respond well to medicine or large clots.

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 of start of symptoms.

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over some possible problems such as:

  • Bleeding
  • Stroke
  • Infection
  • Blood vessel damage
  • Adverse reaction to the anesthesia

The risk of problems is higher if you:

  • Smoke
  • Drink alcohol
  • Have long term disease such as diabetes or obesity

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. One of the following will be used:

  • Local anesthesia—An area will be numbed. You will be awake but won’t feel pain.
  • General anesthesia—You will be asleep.

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. Then the clot will be sucked out. Blood flow should improve immediately. Medicine may be passed through the tube to the area. It will help break up any other clots or stop more from forming.

Once the clot is gone, the tube is removed. The cut is bandaged. Pressure may be kept over the area to stop bleeding.

How Long Will It Take?

Up to 1 hour

How Much Will It Hurt?

Anesthesia will keep you pain-free during the procedure. You will be sore at the insertion site for a few days. Medicine can help to ease pain.

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

The care team will track your vital signs. Pain medicine will be given.

At Home

Recovery time will depend on your overall health.

Call Your Doctor

After you leave the hospital, contact your doctor if you are not getting better or have problem such as:

  • Bleeding
  • Problems speaking clearly
  • Weakness or numbness on one side of the body
  • Lightheadedness, falling, loss of balance
  • Trouble breathing
  • Chest or back pain
  • Pain along the left arm, neck, or jaw
  • Sweating and clammy skin

If you think you have an emergency, call for emergency medical services 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/topics/dmp~AN~T901436/Endovascular-therapy-for-acute-stroke . Updated January 23, 2019. Accessed May 16, 2019.

Ischemic stroke treatment. American Stroke Association website. Available at: https://www.strokeassociation.org/en/about-stroke/treatment/ischemic-stroke-treatment. Accessed May 16, 2019.

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. Updated May 9, 2018.

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 May 16, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 05/2019
  • Update Date: 09/27/2019