Mechanical Thrombectomy: Blood Clot Removal for Acute Stroke

by | Sep 15, 2023

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.

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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) 

Types of Stroke: Ischaemic, Haemorraghic, and TIAs

Learn what you need to know about the different types of strokes, their risks, finding the right doctor, and even some tips on preventing strokes before you see a medical professional.

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.

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.

For more information or to schedule a consultation, we invite you to fill out the form or call our clinic to speak with our care team today.

Stroke Prevention: Causes and Risk Factors

Whether it’s you or a loved one, strokes can be a devastating and serious medical condition to experience. Anyone is capable of having a stroke, but the chances increase if you have certain stroke risk factors, some which are preventable and some which are not.

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,

 

Dr. Manish Taneja performing surgery

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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.

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.

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Brain Aneurysm Resources

Discover brain aneurysm resources that go beyond the basics designed for patients. Understand the meaning of  a brain aneurysm condition, the causes, symptoms, signs, and more. Connect with your brain health.

Put Brain Aneurysm on Your Health Radar

Did you experience the worst headache of your life? Could it be a brain aneurysm that ruptures, which means bleeding in the brain? Thoughts could be racing through your mind. Then what is the difference between unruptured (a weak or thin spot on an artery in the brain that balloons) or ruptured brain aneurysm? If you’re wondering, then the Supreme Vascular and Interventional Clinic is here to help. It’s important to look out for the tell-tale brain aneurysm symptoms, signs, causes, and risk factors.

Dr. Manish Taneja has been performing brain aneurysm treatments since 1995 from surgical clipping to latest minimally invasive procedures. Each patient is unique as is the size and location of the aneurysm. Your brain has different conditions to treat the aneurysm and artery vessel walls of a blood vessel in the brain. This calls for personalised brain aneurysm treatment depending on your symptoms, family, history, medication, and more. A simple 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.