know about Mechanical Thrombectomy

By Ujala Cygnus

Reviewed by : Jalaz Jain

January 28, 2023

Overview

Mechanical thrombectomy treats stroke patients who lack sufficient blood supply to their brains. Lack of blood supply leads to insufficient oxygen supply to the brain. This can cause cell and tissue damage within minutes. However, with the help of mechanical thrombectomy, the damage can be reversed to some extent; in some cases, the damage can be reversed fully.In simple words, Mechanical thrombectomy is a mechanical interventional procedure used to treat clots in your brain. Clots emerge naturally with time as blood vessels in the narrow brain down due t

Who is eligible for a Mechanical thrombectomy?

There are certain criteria that determine the eligibility for a mechanical thrombectomy. One of the major ones is that the patient has to be presented within 6 hours of stroke onset.In addition to this:

The patient must be 18+

He must have an NIHSS score of 6 or above

His MRS score must be between 0-2

In case the patient has missed the 6-hour window he might have to adhere to a few complicated procedures to determine his eligibility.

Prepare yourself for a mechanical thrombectomy

Your healthcare provider may ask you to stop taking certain medications before your thrombectomy. Your doctor may also want to have imaging exams, such as an ultrasound, MRI, or CT scan, performed to help plan your surgery. If your thrombectomy is planned and you have no symptoms of a blood clot, then the procedure may be done in a hospital setting. However, if it’s performed in an emergency, then you may need to be admitted overnight and stay on an IV for fluids and pain management.If you are planning on having a thrombectomy, talk to your healthcare provider about what they recommend.

The Mechanism of mechanical thrombectomy

If you are proven eligible for the procedure then here’s what you can expect to happen during the procedure:

The specialist will make a small incision in your groin or wrist.

Using real-time X-ray-guided imaging, the catheter is threaded through an artery that leads to your neck and brain.

Once we reach the clot, specialists insert a device called the stent retriever into the catheter and advance it past the blood clot.

The device will expand to stretch the walls of the artery and grab the clot.

The stent retriever is then pulled with the clot back through the artery and out through the incision.

Post-op care

Patients are admitted to ICU after the procedure. The first few hours after a thrombectomy is important in assessing the patient’s condition and determining any future treatment. The patient’s neurological status should be assessed at regular intervals, including serial neurological assessments, to determine if there are any signs of neurological compromise.After this time, the patient should continue to be monitored for signs of physiological changes or neurovascular compromise. Physiological changes may include changes in heart rate, blood pressure, respiratory rate, and depth of breathing. Neurovascular assessments can be done to monitor vital signs and assess the integrity of peripheral nerves.

How effective is Mechanical Thrombectomy?

Mechanical thrombectomies are a fast and effective way to treat blood clots. They’re used by doctors when they’re not sure that tissue plasminogen activator therapy will be enough, or if they want to give the patient a second chance at clot removal even after tPA is used.Studies have shown that patients who have mechanical thrombectomies recover faster and have an improved quality of life compared to those patients using clot-busting TPAs alone.Like all medical procedures, Mechanical Thrombectomy might not be ideal for every patient. In an emergency, know that if a tPA isn’t enough to take care of a clot and the patient needs additional treatment options, a mechanical thrombectomy is an available option.

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