a medical procedure to remove a blood clot (thrombus) from an artery or vein using a specialized device. The procedure is typically performed in patients who have suffered from an acute ischemic stroke caused by a blockage in a blood vessel in the brain.
During a mechanical thrombectomy procedure, a catheter (a thin, flexible tube) is inserted through a small incision in the groin and guided to the blood clot site. A specialized device is then used to remove the clot by physically breaking it up or suctioning it out of the artery or vein.
Mechanical thrombectomy is a minimally invasive alternative to traditional surgical procedures, such as embolectomy, which involves surgically removing a blood clot. The process is typically performed by interventional radiologists or neuro-interventionalists trained in using specialized devices to access and treat blood vessels.
Indications of mechanical thrombectomy:
Mechanical thrombectomy is typically performed in patients who have suffered from an acute ischemic stroke caused by a blockage in a blood vessel in the brain. It is most effective when performed within the first 6 hours after the onset of stroke symptoms.
Risks of mechanical thrombectomy:
As with any medical procedure, there are risks associated with mechanical thrombectomy. Potential risks include bleeding, infection, damage to blood vessels, and allergic reactions to contrast dye or anesthesia. There is also a risk of dislodging the clot during the procedure, which can lead to further complications.
Benefits of mechanical thrombectomy:
The benefits of mechanical thrombectomy include improved outcomes for patients with acute ischemic stroke. Studies have shown that the procedure can significantly reduce disability and improve patients' overall quality of life. It can also reduce the risk of death in patients with large vessel occlusion strokes.
Preparation for mechanical thrombectomy procedure:
Before undergoing mechanical thrombectomy, patients will need to undergo several preparations, which may include:
- Diagnostic imaging: To determine if a patient is a good candidate for mechanical thrombectomy, diagnostic imaging tests such as a CT scan, MRI, or angiogram may be performed.
- Blood tests: Patients must have blood tests to assess their clotting factors and overall health.
- Medications: Depending on the patient's medical history and current medications, they may need to stop taking certain medicines before the procedure, such as blood thinners.
- Fasting: Patients will be required to fast for a certain period before the procedure, typically 6 to 8 hours.
- Anesthesia: Mechanical thrombectomy is usually performed under local anesthesia, meaning the patient will be awake but numb in the area around the insertion site. In some cases, general anesthesia may be required.
- Consent: Patients must sign a consent form indicating that they understand the risks and benefits of the procedure.
- Preparation of the insertion site: The area where the catheter will be inserted (typically the groin) will be cleaned and shaved, and the patient may be given a mild sedative to help them relax.
Overall, mechanical thrombectomy can be a highly effective treatment for acute ischemic stroke, but it is essential to carefully consider the risks and benefits before deciding on the best course of treatment for each patient.
After mechanical thrombectomy:
patients will require close monitoring and care to ensure a successful recovery. The specifics of post-procedure care will depend on the individual patient's condition and the details of the procedure, but some general aspects of post-procedure care may include:
- Observation: Patients will be monitored closely for several hours after the procedure to check for any signs of bleeding, infection, or other complications.
- Bed rest: Patients will typically need to remain in bed for several hours after the procedure to allow the insertion site to heal and reduce bleeding risk.
- Medications: Patients may be given drugs to prevent blood clots or to manage pain and discomfort.
- Fluids and nutrition: Patients may be given intravenous fluids and nutrition to help them recover.
- Follow-up appointments: Patients must attend follow-up appointments with their doctor to monitor their recovery and adjust their medications or treatment plan if necessary.
- Rehabilitation: Patients may require rehabilitation or physical therapy to regain strength, mobility, and other skills lost as a result of their stroke
Patients are expected to follow their doctor's instructions carefully to ensure a successful and safe procedure.