Mechanical thrombectomy is a breakthrough, minimally invasive procedure used to remove clots from brain arteries and restore blood flow in patients experiencing severe strokes. At our specialized stroke clinic in Singapore, we offer this advanced treatment to help patients recover quickly and reduce long-term complications.
Mechanical Thrombectomy for Acute Ischemic Stroke: A Life-Saving Treatment
An acute ischemic stroke is a medical emergency that occurs when a blood vessel that supplies blood to the brain is blocked, reducing blood flow and damaging cells. If blood cannot reach that area, oxygen is not delivered. When an individual experiences an ischemic stroke, it is critical to intervene as swiftly as possible to minimize brain damage and improve outcomes.
Mechanical thrombectomy is a leading treatment for large vessel occlusion (LVO) and medium vessel occlusion (MVO) strokes. It is a minimally invasive procedure widely used and very effective to remove blood clots and restore blood flow to the brain in order to treat ischemic strokes.
If you're interested in reaching out to a stroke specialist in Singapore, for mechanical thrombectomy, learn about acute ischemic stroke and how mechanical thrombectomy can help.
Common Questions About Mechanical Thrombectomy for Acute Ischaemic Stroke
What is a mechanical thrombectomy?
A mechanical thrombectomy is a minimally invasive, image-guided procedure used to remove a blood clot blocking a major artery in the brain during an acute ischaemic stroke.
A specialist inserts a thin catheter through an artery, usually in the wrist or groin, and carefully guides it to the blocked brain artery. Specialised devices are then used to remove the clot and restore blood flow to the affected area of the brain.
For carefully selected patients, mechanical thrombectomy can significantly improve outcomes when performed as quickly as possible.
Who may be suitable for a mechanical thrombectomy?
Not every patient with a stroke is suitable for mechanical thrombectomy.
Specialists consider several factors, including:
- Whether the stroke is ischaemic (caused by a blood clot)
- The location and size of the blocked artery
- Brain imaging findings (CT, CT Angiography or MRI)
- The amount of brain tissue that may still be saved
- How much time has passed since symptoms began
- The patient's overall health and medical history
Advanced imaging helps determine whether the procedure is likely to provide meaningful benefit.
How is mechanical thrombectomy different from clot-busting medication?
Intravenous thrombolysis (clot-busting medication) uses medication to dissolve blood clots, whereas mechanical thrombectomy physically removes the clot using specialised devices.
Some patients receive:
- Clot-busting medication alone
- Mechanical thrombectomy alone
- Both treatments, depending on the clinical situation
Your stroke team determines the most appropriate treatment based on your symptoms, imaging findings and timing.
What happens after a mechanical thrombectomy?
After the procedure, patients are closely monitored in hospital.
Recovery may include:
- Neurological observation
- Repeat brain imaging where appropriate
- Medication to reduce future stroke risk
- Physiotherapy
- Occupational therapy
- Speech and language therapy if required
- Ongoing rehabilitation and follow-up
Recovery varies depending on the severity of the stroke and how quickly blood flow was restored.
How quickly should a mechanical thrombectomy be performed?
Stroke is a medical emergency.
The sooner blood flow is restored, the greater the opportunity to preserve healthy brain tissue.
This is why anyone experiencing symptoms such as facial drooping, arm weakness or difficulty speaking should seek emergency medical attention immediately. Rapid assessment and brain imaging help determine whether emergency treatments, including mechanical thrombectomy, may be appropriate.
What is an Acute Ischemic Stroke?
An acute ischemic stroke is caused by decreased blood flow to the brain, resulting in damage to the blood cells. In Singapore, stroke is the fourth leading cause of death, the leading cause of adult disability, and has a prevalence of 4% among adults aged 50 years and above.
Acute ischemic stroke has many symptoms, including:
- Sudden numbness or weakness in the face, arm, or leg (especially on one side of the body)
- Sudden confusion, issues with speaking, or difficulties with understanding speech
- Sudden issues with walking, dizziness, loss of balance or coordination
- Sudden difficulties with seeing in one or both eyes
The American Heart Association and National Stroke Association use the FAST acronym to help educate individuals on whether they are experiencing stroke and whether it's time to seek professional help. FAST stands for:
- F: Face drooping
- A: Arm weakness
- S: Speech difficulties
- T: Time to call 9-5-5
Seek medical help immediately if you are experiencing any of these symptoms and visit our article to learn more on how to spot a stroke F.A.S.T.
Understanding Mechanical Thrombectomy
Thrombectomy is a surgical procedure to remove a thrombus or blood clots from a vein or artery to restore blood flow. It happens when a clot, often originating from another part of the body, travels to the brain and gets stuck in a blood vessel. This blockage prevents oxygen-rich blood from reaching the brain, leading to ischemia, or oxygen deprivation, which can result in significant brain damage. The damage caused by this lack of oxygen can lead to lasting effects like difficulty with speech, partial paralysis, and mobility issues, depending on the region of the brain affected and the severity of the injury. This procedure is often used for patients with ischemic stroke and other conditions. Thrombectomy can significantly reduce the risk of death or permanent disability when done properly.
Thrombectomy Procedure
Patients with large vessel occlusions (LVOs) and medium vessel occlusions (MVOs) and individuals who arrive within a certain window of time after stroke onset qualify for thrombectomy. Here is an overview of mechanical thrombectomy:
- The stroke surgeon makes a small incision in the thigh or wrist to access the arteries.
- A catheter is carefully guided through the arteries using advanced imaging technology to reach the clot in the thrombus (where the blockage is).
- Once the clot is located, the surgeon uses a stent retriever or aspiration device, a mesh-like device, to trap the clot.
- The stent retriever is deployed through the catheter to ensnare the clot within its mesh.
- The clot is then pulled out along with the stent retriever, restoring blood flow to the affected area of the brain. This procedure is done as quickly as possible to reduce brain damage, typically within hours of stroke symptom onset.
Benefits of Mechanical Thrombectomy
- Reduce several risks: Thrombectomy can reduce the risk of severe disability, loss of limbs, and death.
- Limit damage: Thrombectomy can limit damage and loss of bodily functions by restoring blood flow as quickly as possible.
- Effective: Mechanical Thrombectomy is a relatively safe and effective procedure. It is straightforward and recovery is pretty quick. Thrombectomy is far less invasive.
Stroke Treatment Recovery
After a thrombectomy, your healthcare professional may have you get up and move shortly after surgery to lower the risk of blood clotting. Your healthcare provider will also prescribe a care plan to help you recover. The care plan may include medications, such as blood thinners and thrombolytics.
Compression socks may also be provided to prevent a new clot from forming. Additionally, your provider will recommend moderate exercise to help with rehabilitation.
Recovery time will depend on the patient's particular situation. During recovery, it's essential to partake in ongoing stroke prevention measures. Individuals will need to monitor blood pressure to make sure it's stable.
For individuals living with diabetes, managing their condition by checking blood glucose and taking their medication is key. Individuals should also limit or cut out smoking.
When to See a Neurointerventional Stroke Specialist
Mechanical thrombectomy is a highly specialised procedure performed in selected patients with acute ischaemic stroke. Although it is an emergency treatment, specialist follow-up remains important after hospital discharge.
You may benefit from ongoing review by a neurointerventional or stroke specialist if you:
- Have undergone a mechanical thrombectomy
- Have experienced an ischaemic stroke or transient ischaemic attack (TIA)
- Have questions about the cause of your stroke
- Need advice on reducing the risk of another stroke
- Have carotid artery disease or another cerebrovascular condition
- Would like a second opinion regarding stroke treatment or recovery
- Require long-term follow-up after minimally invasive stroke treatment
Follow-up appointments typically include reviewing brain imaging, identifying the underlying cause of the stroke, discussing medications, monitoring recovery and developing a personalised long-term prevention plan. Patients and families also have the opportunity to ask questions and better understand recovery expectations.
Seek emergency medical attention immediately if you experience sudden facial drooping, weakness or numbness on one side of the body, difficulty speaking, sudden vision loss, severe dizziness, loss of balance or a sudden severe headache. These symptoms may indicate a stroke and require immediate treatment.
Receive Acute Ischemic Stroke Treatment in Singapore with Supreme Vascular and Interventional Clinic
There are many types of strokes and not all qualify for mechanical thrombectomy. If you or a loved one has experienced a stroke, speak with a stroke specialist to learn whether mechanical thrombectomy is an option.
The Supreme Vascular and Interventional Clinic, a specialized stroke clinic, provides comprehensive management of neurointerventional and vascular conditions with minimally invasive treatment options. Learn more about stroke care and discuss treatment options with us by contacting us today to arrange an appointment with our stroke specialist, Dr. Manish Taneja, in Singapore.
Read More About Neurointerventional Treatments on Our Blog
To dive deeper into the types of neurointerventional treatments, head over to our clinic’s blog.
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We've Got You Covered for Specialized Stroke Screening, Prevention, and Management
Imagine heart attacks where the blood flow to your heart is blocked. Similarly, a stroke occurs when the blood flow to your brain is interrupted becoming a "brain attack". When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes (blockage of blood vessel due to blood clot) or a mini stroke, a TIA (transient ischemic attack), with no permanent damage yet serious. Stroke also occurs when a blood vessel in the brain pops causing bleeding in the brain.
When a stroke occurs, the symptoms of stroke depend on how blood flow to the brain is affected. Individuals at high risk and even higher risk (family history) often have high blood pressure, atrial fibrillation, or another risk factor for stroke, all of which increase the risk of stroke. Disrupted blood flow can even damage the blood vessel in the brain and affect one side of the body. Having a stroke doesn’t mean it has to lead to permanent disabilities. Recognizing early warning signs is essential to reduce the risk, and in some cases, procedures such as carotid endarterectomy may help increase the blood vessel in the brain and restore healthy circulation.
Certain areas of the brain can be affected by stroke and some symptoms of a stroke including cardiovascular disease, diabetes, and high blood sugar levels increase the risk of stroke whereas an active lifestyle or controlling high cholesterol reduces the risk. How well do you know stroke? Find tips to prevent and manage stroke, the differences in stroke screening tests, and the newer technology and treatments available. Come in for an easy consultation and further evaluation with our stroke specialist in Singapore at the Supreme Vascular and Interventional Clinic.
Supreme Vascular and Interventional Stroke Programs
Neurointerventional / Stroke Treatments
The Supreme Vascular and Interventional Clinic is your "go-to" facility for various neurointerventional / stroke conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our stroke specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.