What is Mechanical Thrombectomy for Ischemic Stroke

Mechanical thrombectomy is a procedure to treat an ischemic stroke. This type of stroke is caused by a blood clot in an artery in your brain. The clot blocks the blood supply to your brain.

This is a medical emergency. It must be treated immediately.

The first treatment for this type of stroke is to get medicine (tPA). This medicine dissolves the clot. This medicine is given through an IV tube. Afterwards, this procedure will be done to take out any part of the clot that is left.

What happens during the procedure?

• To help prevent infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• You will be given one or more of the following through the IV tube used to give you tPA:

• A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your doctor will make a small cut (incision) in your upper thigh area to find a large artery.
• A long, thin tube (catheter) will be put into the artery.
• The long, thin tube will be passed up toward your brain.
• Imaging tests will be done to find the exact spot in your brain to place the long, thin tube.
• A wire-like basket (stent retriever) will be extended from the long, thin tube to remove the blood clot. In some cases, your doctor may also use a suction tool.
• Your doctor will take out the long, thin tube.
• You will have a bandage (dressing) placed where the long, thin tube was inserted.

The procedure may vary among doctor and hospitals.

What happens after the procedure?

• Your heart rate, breathing rate, and blood oxygen level will be monitored often. This will be done until the medicines you were given have worn off.
• You may still get IV fluids.
• The following will be closely watched:
  • Your blood pressure.
  • Your blood sugar.
  • Your brain function.
• You may get medicine to help prevent another blood clot.

Mechanical Thrombectomy for Ischemic Stroke, Care After

These instructions give you information about caring for yourself after your procedure. Your doctor may also give you more specific instructions. Call your doctor if you have any problems or questions after your procedure.

Follow these instructions at home:

Insertion Site Care

• Follow instructions from your doctor about how to take care of your insertion site. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If you cannot use soap and water, use hand sanitizer.
  • Change your bandage as told by your doctor.
• Check the insertion site every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your doctor.
• Return to your normal activities as told by your doctor. Ask your doctor what activities are safe for you.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your doctor.
• Keep all follow-up visits as told by your doctor. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your insertion site.
• Your insertion site feels warm to the touch.
• You have a fever.

Get help right away if:

• You have more fluid or blood coming from your insertion site.
• You have pus or a bad smell coming from your insertion site.
• You have symptoms of another stroke. These include:
  • A drooping face.
  • Arm weakness.
  • Trouble with speech.

These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.