A mechanical thrombectomy is a minimally invasive technique where a clot in the artery of a patient is eliminated by an interventionist radiologist or an endovascular neurosurgeon using specialized equipment.
Indication
Arterial obstructions caused by blood clots are treated using this method. A mechanical thrombectomy can treat the following conditions:
A blood clot that develops in a vein is known. Deep vein thrombosis (TVP). Althheheyh can also happen in the arms, the DVT most frequently arise on the legs. Vein valves can sustain irreversible damage as a deep vein thrombosis (TVP). The placement of problems, discomfort and swelling are some of the long -term problems that can result from this. Another risk associated with DVT is the potential for the clot to separate and travel to the lungs. If this happens, the clot can ultimately obstruct the blood flow and result in a potentially lethal pulmonary embolism.
Antique Ischemic stroke It occurs when a blood clot forms in an artery that supplies blood to the brain or in another part of the body and is swept to a cerebral artery. As a result, the blood flow of the brain slows down or stops. Permanent brain injury can occur in minutes. Recovering ischemic gloom is the main objective of mechanical thrombectomy in cases of ischemic stroke. Recent research has demonstrated the effectiveness of mechanical thrombectomy and its superiority over intravenous thrombolytic (IV), resulting in a significant expansion of their indications. The following standards for endovascular mechanical thrombectomy therapy are suggested by the patterns of the American Heart Association/American Cerebrovascular Accident Association for the early management of acute ischemic strokes:
- Nih ≥ 6 stroke of stroke; Early CT score of the Alberta Cerebrovascular Accident Program ≥ 6; Modified pre-screke rankin scale <2
- Commission within six hours after the start of symptoms
- Acute blocking of the proximal average cerebral artery (M1) or the internal carotid artery
- 18 years of age or more
In certain patients with large vascular ischemic stroke who presented up to 24 hours after the start of symptoms, studies showed that mechanical thrombectomy improved clinical results compared to standard therapy alone. The time frame for thrombectomy has been extended 24 hours after the start of the symptoms according to the current indications.
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Contraindications
- Cerebral hemorrhage
- A large infarction core
- Small vessel occlusion
- Coagulopathies that are incurable
- Excessive blood pressure that is fully (systolic> 185 mmHg or diastolic> 110 mmhg)
PROCEDURE
- A small incision is made in its wrist or groin by an endovascular specialist.
- A catheter is inserted through an artery that supplies its brain and neck using X -ray guided images in real time.
- Experts advance the catheter conforms to the blood clot after inserting a device (stent retriever) into it.
- To understand the clot and stretch the arterial walls, the device expands.
- After that, the elimination of the stent is carried out through the incision and the back through the artery with the clot.
According to studies, people who undergo mechanical thrombectomy recover more rapidly and have a high quality of life than those who only use tissue plasminogen activators, also known as coagulous ta. The treatment for blood clots should be fast and efficient because they are a significant medical problem.
However, not all are a good candidate for mechanical thrombectomies, such as many surgical operations. In an emergency, keep in mind that a mechanical thrombectomy, a viable alternative if a TPA is insufficient to treat a clot.
