Thrombectomy: A Life-Saving Treatment for Stroke

A stroke occurs when the blood flow to the brain is blocked by a clot in one of the large vessels of the brain. Fast treatment is critical to limit brain damage and improve the chances of recovery.

“We have a saying in the field of stroke: “Time is brain,” says Amrou Sarraj, MD, a vascular neurologist and Director of the Cerebrovascular Center and Comprehensive Stroke Center at University Hospitals. “When you have a stroke, you lose about two million neurons every minute,” he says. “Earlier care results in better outcomes for patients.”

How Thrombectomy Treats Strokes

Thrombectomy is a minimally invasive surgery that’s highly effective at removing clots from blood vessels. If a thrombectomy is performed within 24 hours of a stroke, the procedure may be able to help limit brain damage and reduce the risk of long-term disability.

“We try to perform this procedure as soon as possible,” says Dr. Sarraj. The earlier the treatment, the more brain cells thrombectomy may be able to help save – and the better the outcome for the patient.

“We use this procedure to access the blood vessels through the groin or hand, and we pass a small tube with a device on it through the vessels to capture or break up the clot,” Dr. Sarraj says. “This restores the blood flow and may help save the brain tissue that was being deprived of blood, improving the patient’s chances of recovery.”

Thrombectomy can restore blood flow to other parts of the body too. “The procedure is similar when it’s used to remove clots from arteries of the leg or arteries of the lung when a clot blocks the blood flow,” he says. “The devices used are a bit different, though.”

Who Is Eligible for a Thrombectomy?

Whether someone qualifies for a thrombectomy depends on several factors. To determine the best course of treatment, a patient’s stroke care team will consider:

• Where the clot is.
• How big the stroke looks on brain imaging.
• When the stroke symptoms started.
• If the changes caused by the stroke are too advanced.
• Any pre-existing disabilities the patient may have.

“Treatment may include clot-busting medications, a thrombectomy procedure, both or neither,” says Dr. Sarraj. A thrombectomy has a higher chance of restoring blood flow than medication, but it can only be performed if the patient has a blockage in one of the large arteries of the brain. “Clot-busting medications can be given to a larger population,” says Dr. Sarraj. “If the patient is eligible, we give them both clot-busting medication and the thrombectomy procedure.”

Are There Risks?

For eligible patients, thrombectomy for stroke can help preserve brain function, improve recovery and may even save some people’s lives. “Like any other medical procedure, thrombectomy also has risks,” says Dr. Sarraj.

Risks include:

• Bleeding into the brain.
• Spasm of the blood vessels.
• Injury to blood vessels.
• Infection of the wound or surrounding area.

Where Are Thrombectomies Performed?

Thrombectomy is typically performed at hospitals that have dedicated stroke teams and equipment. The stroke team may include an emergency department physician, as well as other specialists, such as neuroradiologists, neurologists, neurointensivists, cerebrovascular neurosurgeons and others. Such specialists can assess whether a thrombectomy is right for the patient and perform the procedure or other interventions, as necessary.

“University Hospitals is at the forefront of research into how we can make more patients eligible for thrombectomy and other life-saving treatments for stroke,” says Dr. Sarraj.

Stroke Prevention and Response

Most strokes are caused by risk factors you can help control. Quitting smoking, limiting alcohol, managing blood pressure and cholesterol, and maintaining a healthy weight are some of the steps you can take to help protect your blood vessels and reduce your risk of stroke.

If you do suspect a stroke, call 911 and get medical attention immediately. “Stroke can occur any time to anyone,” says Dr. Sarraj. “Recognizing symptoms and seeking care at the earliest is of paramount importance,” he says.

Related Links

The board-certified stroke specialists at University Hospitals Comprehensive Stroke Center include vascular neurologists, neurosurgeons, neuro-critical care intensivists and interventional specialists, all of whom work together to combine their training and skill to handle the most complex neurovascular disorders.