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Thrombectomy: Removing a stroke-causing clot

Posted on May 3, 2019 in Stroke

Procedure can result in better outcomes for stroke patients

Dr. Woodward and Dr. Hixson work on the computerWhen the American Heart Association and American Stroke Association included thrombectomy as part of the standard protocol for patients who are experiencing acute ischemic stroke, neurointerventional radiologist Keith Woodward, MD, wasn’t surprised. He had already been performing the procedure for about 10 years and had seen dramatic results.

“Many patients improve within 24 hours,” Dr. Woodward says. “For some patients it only takes a few hours, and some patients experience a change in their condition immediately.”
If the body is working the way it should, blood will flow freely through blood vessels, arteries and veins, carrying oxygen and nutrients where they’re needed. When the blood flow to part of the brain is cut off by a clot, brain cells can’t get the oxygen they need and begin to die.

This can have an effect on anything the brain controls, from memory to muscles. Thrombectomy is a way to physically go into the brain and directly deal with a stroke-causing clot.

While tissue plasminogen activator (tPA) is an excellent treatment for breaking down blood clots, it doesn’t always work for every patient who is experiencing an ischemic stroke. During a thrombectomy, a neurointerventional radiologist can thread a small catheter through the groin all the way up to the brain and use a gentle vacuuming process to pull the clot free.

“I know when I’ve got it,” Dr. Woodward says. “When it starts to come out it’s kind of like fishing. You know you’ve got something on the line.”

First, there’s an incision in a blood vessel. The clot is then removed, and the blood vessel is repaired. In some cases, a balloon or other device may be implanted to help the blood vessel stay open.

Thrombectomy can mean the difference between a patient merely surviving a stroke, and a stroke patient returning to a full and active lifestyle.