February 9, 2022

Mechanical Thrombectomy For Ischemic Stroke

What Is Ischemic Stroke?

When the brain starves out due to oxygen deficiency, massive tissue damage occurs leading to a medical emergency, i.e. stroke. An ischemic stroke usually occurs due to the clogging of a brain blood vessel(artery) by a clot that stops the blood supply to the brain.

However, it is possible to reverse the damage to a certain extent by doing a timely mechanical thrombectomy for acute ischemic stroke. Mechanical thrombectomy helps in removing the clot from the artery supplying blood to the brain.

How does Mechanical Thrombectomy help in Ischemic Stroke?

Blood vessels that supply blood to the brain may get narrowed due to deposition of fats/plaque. Patients with high blood pressure or cholesterol, diabetes or who are smokers are prone to such medical problems. Such plaques hamper the normal blood flow in the brain and can be detected by imaging techniques like CT scans or MRI scans for the estimation of the blockade.

Mechanical thrombectomy is recanalization or re-opening of the blocked blood vessels to restore or re-establish normal blood circulation.

Factors Affecting outcomes of Mechanical Thrombectomy For Ischemic Stroke

There a lot of factors that can hamper the mechanical thrombectomy prognosis are:

  • Patients may be unaware of the symptoms of brain stroke, so, they may not realize the need for any immediate treatment. The intra-arterial thrombectomy application should be done at the earliest.. This window period for treatment is maximum upto 24 hours from the last known normalcy depending on the location of block and how much brain has already been damaged. Often the brain is already damaged eyond salvage with the first 3-4 hours. Therefore, patient should reach the hospital at the earliest.
  • Lack of equipped hospitals or facilities to perform mechanical thrombectomy immediately. In such cases, intravenous intervention can be done to manage the situation temporarily and patient should be referred to a center equipped for doing thrombectomy at the earliest.

How is Mechanical thrombectomy performed?

For large blood clots, mechanical thrombectomy was performed hollow suction tubes and a clot retrieving mesh (stent retriever).

In this process, a catheter bearing a stent retriever is introduced beyond the site of blood occlusion using X-ray imaging. . The stent is allowed to expand, engage the clot  and pulled out, thereby, removing the clot. This results in restoration of  the blood flow to the oxygen-deficient brain area.

The success rate of mechanical thrombectomy is higher than any other procedure for ischemic stroke. It often provides immediate effects and helps in reviving the damaged cells.. and some patients have recovery on the procedure table itself. Howere, the recovery may be slow in other patients, with continuing improvement up to 3 months.