Mechanical Thrombectomy: Blood Clot Removal for Acute Stroke
Mechanical thrombectomy is an advanced treatment option for ischemic stroke that can improve outcomes compared to medication alone. It aims to quickly reopen blocked vessels to minimize permanent damage to the brain.
Acute ischemic stroke is a medical emergency that can lead to permanent disability or death if not treated urgently. When intravenous clot-busting medication fails to restore blood flow, mechanical thrombectomy has become the most effective procedure for removing vessel clots in the brain. This minimally invasive endovascular surgery is performed by specially trained neurointerventional specialists. At Supreme Vascular and Interventional Clinic in Singapore, Dr. Manish Taneja provides world-class mechanical thrombectomy care using the latest techniques and imaging.
This article will provide an overview of how thrombectomy works, the types of strokes treated, what to expect, and why our clinic is the right choice for stroke care.
What is Mechanical Thrombectomy?
Mechanical thrombectomy is a minimally invasive procedure used to remove blood clots in patients experiencing an acute ischemic stroke. It involves inserting a catheter into an artery (the femoral artery in the leg or radial artery at the wrist) and threading it through the vascular system to the site of the clot obstructing blood flow in the brain. A special device on the catheter is used to capture and remove the clot, restoring blood flow and oxygen to the affected area of the brain.
Mechanical thrombectomy is an advanced treatment option for ischemic stroke that can dramatically improve outcomes compared to medication alone. It aims to quickly reopen blocked vessels to minimize permanent damage to the brain.
Mechanical Thrombectomy Overview and Acute Ischemic Stroke
An acute ischemic stroke occurs when a blood clot blocks an artery supplying blood to the brain. It accounts for about 87% of all strokes. Without treatment, affected brain cells start dying within minutes. This can result in long-term disability or death depending on the location and size of the blocked vessel.
When a stroke is diagnosed within 4.5 hours of onset of symptoms, the main treatment is intravenous thrombolysis "clot-busting" medication such as tissue plasminogen activator (tPA). However, studies show this only works to dissolve the clot in about 1 out of 3 patients.
Mechanical thrombectomy was introduced as a treatment to physically remove the clot in patients who don't respond to thrombolysis drugs alone. It has been a revolutionary advancement, demonstrating superior outcomes compared to medication by itself.
When Is It Recommended?
According to American Heart Association guidelines, mechanical thrombectomy is recommended for treatment of acute ischemic stroke when:
- It can be initiated (groin or wrist area puncture) within 6-24 hours of time last known well. The sooner the better.
- Non-invasive vascular imaging (such as terminal internal carotid, M1 middle cerebral artery) that can be accessed by endovascular techniques.
- There is evidence of salvageable brain tissue and small infarct core volume.
- It can be done in conjunction with tPA drug treatment.
The Procedure (Minimally Invasive Technique)
Mechanical thrombectomy is a minimally invasive image-guided surgery performed by an endovascular neurosurgeon or interventional neuroradiologist. Here is an overview:
- After diagnosis of a clot using CT or MRI scanning, the patient is brought to the endovascular suite.
- The groin or wrist area is cleaned and numbed with local anesthetic. A small puncture is made to insert a catheter into the femoral artery or radial artery.
- The catheter is threaded through the aorta to the site of the clot in the brain under continuous live x-ray guidance (fluoroscopy).
- When in place, a tiny cage-like device called a stent retriever or aspiration device is deployed from the catheter to capture and ensnare the clot.
- The clot is secured and the catheter slowly pulled back out of the body along with the captured clot.
- The stent and clot are removed once outside the body, restoring blood flow to the brain. Hemostasis (sealing of the puncture site) completes the procedure.
From groin puncture to revascularization usually takes within 1 hour. Patients are monitored in intensive care post-procedure.
Types of Stroke Treated Using Mechanical Thrombectomy
The most common types of stroke treated with mechanical thrombectomy include:
- Large Vessel Occlusion (LVO)
- Middle and Small Vessel Occlusion
- Tandem Occlusions
- Basilar Artery Occlusion
- Vertebral Artery Dissections
- Acute Stroke Secondary to Cancer (Trousseau Syndrome)
What to Expect with Mechanical Thrombectomy
Mechanical thrombectomy takes place in a specially equipped endovascular suite instead of an operating room. The procedure involves:
- Insertion of a catheter into the femoral artery at the groin or radial artery at the wrist under local anesthesia. This is a minimally invasive puncture with a needle.
- Navigating the catheter through blood vessels to the clot.
- Deploying the stent device to capture the clot, then slowly removing it. You may feel nothing or just slight pressure.
- You will be moved to intensive care post-procedure for close monitoring. Your vessels will be checked.
- If the procedure is successful, symptoms should start improving relatively rapidly as blood flow is restored to the brain region affected by the stroke.
- Recovery involves physical and occupational therapy to regain strength and skills impacted by the stroke.
Why Choose Supreme Vascular and Interventional Clinic in Singapore
When facing a major health emergency like an acute ischemic stroke, getting treated quickly by specialists with extensive expertise can make the difference in survival and recovery.
Supreme Vascular and Interventional Clinic provides world-class mechanical thrombectomy services with:
Skilled and Experienced Specialist
- Dr. Manish Taneja is a leading Interventional Neuroradiologist in Singapore who has performed successful mechanical thrombectomies. His skill level and experience translates into better outcomes.
Advanced Imaging
- Our clinic uses the latest imaging equipment including biplane angiography for procedure guidance and CT/MRI for diagnostic accuracy. This is vital for brain perfusion analysis and treatment.
World Class Care in a Private Setting
- We offer world-class medical care with comfort, privacy, and personalized attention at our clinic. You are in caring hands with our compassionate staff.
Let Our Stroke Specialist, Dr. Manish Taneja, Help - Reach Out Today
Mechanical thrombectomy is an advanced minimally invasive procedure that can dramatically improve treatment of acute ischemic stroke compared to medications alone. It quickly restores blood flow to oxygen starved regions of the brain by removing the clot. Learn more on how specialists decide when thrombectomy is appropriate in our comprehensive Stroke Decision Making guide.
At Supreme Vascular and Interventional Clinic, Dr. Manish Taneja provides mechanical thrombectomy performed by one of Singapore's top interventional neuroradiology specialists. Discover how our world-class expertise and advanced imaging can provide you or your loved one life-saving care in a private, attentive setting. We invite to contact our clinic to schedule a consultation with him today.
Consult a Stroke Specialist in Singapore
Dr. Manish Taneja, is an expert in endovascular and image guided neurointerventional procedures of brain and spine. It's important to find a stroke specialist and doctor you can trust in Singapore. He has special interest in treatment of brain aneurysms, stroke and vascular malformations. Come in for a further evaluation. Arrange an appointment with Dr. Manish Taneja, our neurointervention specialist,
Stroke Resources
Stroke Prevention Tips: How to Avoid High Cholesterol
Controllable risk factors are lifestyle choices that can be changed to reduce the risk of having a stroke including managing your cholesterol.
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”, affecting a blood vessel and surrounding brain function. When blood supply does not reach a certain part, brain cells begin to die. Different types of stroke include ischemic strokes or a mini stroke, a TIA (transient ischemic attack). Common risk factors include high blood pressure, which increases strain on the blood vessel and raises the likelihood of a stroke. Symptoms can vary, but may include difficulty in speaking and other changes depending on how blood flow is affected. Understanding risk factors and acting early can make a difference. It’s important to work closely with a specialist to monitor your health and reduce stroke risk.
Brain Aneurysm Resources
Explore our brain aneurysm resources. Understanding a brain aneurysm often involves learning across several areas.
Put Brain Aneurysm on Your Health Radar
Did you experience the worst headache of your life? Thoughts could be racing through your mind. A brain aneurysm is a weak spot in a blood vessel in the brain that can change over time. The key concern is when an aneurysm ruptures, which can disrupt blood flow, affect brain tissue, and lead to serious brain damage. Controllable conditions like high blood pressure can increase this risk and treatment options can depend on the condition. Surgical clipping is one option that prevents blood from entering the weakened area. In many cases, minimally invasive treatments can also be used to restore normal blood flow and reduce risk. We have created structured guides to help you explore each stage in more detail:
A simple (computed tomography) CT scan could be just what the doctor ordered and the first step in early detection and prevention of a brain aneurysm. Come in for an easy consultation with our brain aneurysm specialist in Singapore to be on your health radar.
Other Health Conditions
The Supreme Vascular and Interventional Clinic is your “go-to” facility for various neurological conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our neurointervention specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.