Stroke is a life-threatening medical emergency that occurs when blood flow to a part of the brain is disrupted, either due to a clot or a ruptured blood vessel.

Acute stroke requires immediate medical attention, as every minute without treatment results in the death of 1.9 million brain cells. Treatment for acute stroke has evolved over time, with new advances in medical technology and research bringing forth more effective treatment options.

Endovascular thrombectomy is one such intervention that has revolutionized the treatment of acute stroke.

What is Endovascular Thrombectomy?

Endovascular thrombectomy is a minimally invasive procedure that involves the use of a catheter to remove a blood clot or thrombus from an artery in the brain.

The procedure is performed under local anesthesia, and the patient remains conscious throughout the procedure. The catheter is threaded through a small incision in the groin and steered to the affected artery using imaging guidance. Once the catheter reaches the clot, a small suction device is used to break up and remove the clot.

The procedure takes between one to two hours.

How Does Endovascular Thrombectomy Benefit Stroke Patients?

Endovascular thrombectomy is especially beneficial for patients who have suffered a severe stroke, as it can improve their chances of survival and reduce the risk of disability.

Traditional treatment for acute stroke involves administering a clot-busting medication called tissue plasminogen activator (tPA) within three hours of the onset of symptoms. However, tPA is not always effective in dissolving the clot and restoring blood flow to the affected area.

Additionally, tPA can only be administered to a small proportion of patients who meet specific criteria, such as those with milder strokes and no history of bleeding or severe hypertension.

Endovascular thrombectomy, on the other hand, can effectively remove the clot from the affected artery and restore blood flow within the brain tissue.

This reduces the likelihood of further damage to the brain, leading to better outcomes for the patient. In fact, research has shown that endovascular thrombectomy can improve functional outcomes in patients with severe strokes, reducing the risk of disability and improving survival rates.

When is Endovascular Thrombectomy Recommended?

Endovascular thrombectomy is recommended for patients with large vessel occlusion (LVO) stroke, a severe form of stroke that occurs when a clot blocks a large artery in the brain.

LVO stroke is associated with poor outcomes, with up to 60% of patients experiencing disability or death within three months of the event. Endovascular thrombectomy can remove the clot and restore blood flow to the affected area, which is particularly critical in patients with LVO stroke.

Endovascular thrombectomy is typically performed within six hours of the onset of symptoms, although research has shown that the procedure can be effective up to 24 hours after the onset of symptoms in selected patients who meet specific criteria.

Therefore, it is crucial that patients with suspected acute stroke seek medical attention as soon as possible to increase their chances of benefitting from endovascular thrombectomy.

What are the Risks Associated with Endovascular Thrombectomy?

Endovascular thrombectomy is generally safe and well-tolerated, with a low risk of complications. However, as with any medical procedure, there are some risks involved.

The most common side effects include groin pain, bleeding, and infection at the site of the incision. In rare cases, the catheter may cause damage to the artery, leading to bleeding or stroke. Patients should discuss the potential risks and benefits of the procedure with their physician before undergoing endovascular thrombectomy.

Conclusion

The use of endovascular thrombectomy has revolutionized the treatment of acute stroke, particularly in patients with severe forms of the condition.

This minimally invasive procedure can effectively remove blood clots from the arteries in the brain, restoring blood flow and reducing the risk of disability and death. Patients with suspected acute stroke should seek medical attention as soon as possible to determine if endovascular thrombectomy is appropriate for their condition.