77 year old gentleman Chandregowda (name changed) presented to our ER with sudden onset difficulty in speech, right upper limb weakness and inablity to walk. MRI revealed Acute ischemic stroke involving the left MCA territory with a clot in one of the major arteries (superior branch of M2 sgement MCA) which was supplying his left side of brain. As he was in the stroke window period , thrombolysis (Clot dissolving medicine) was administered and he was taken up for Mechanical thrombectomy by Interventional Radiology team. Brain Angiogram confirmed occlusion of superior branch of left M2 MCA. Small microcatheter was placed distal to the occluded segment and stent retriever was deployed. After waiting for 5 minutes, mechanical thrombectomy was done with continuous suction. Check angiogram showed complete recanalization of left M2MCA. Immediately after the procedure, the power in his right upper limb started to improve and he started to speak few words. Patient was shifted to the ICU for further observation. Further improvement was noted in the speech and power of right upper and lower limb in the next few days. He was discharged after 4 days and the patient went back home walking with preserved speech.

What is stroke window period?

First 6 hours is the most crucial and considered the golden period after stroke. However, mechanical thrombectomy can be performed upto 24 hours in select individuals depending on the parameters.

What is mechanical thrombectomy?

Mechanical thrombectomy is a minimally invasive surgery/ procedure aimed at retrieval of the clot from brain circulation. Interventional Radiologist usually enters the brain arteries through a small hole in the groin and clot in brain is removed either through aspiration/ stent retriever.

What are the success rates of mechanic thrombectomy?

Careful case selection and expertise in performing the procedure is the key for successful outcomes. Technical success of mechanical thrombectomy ranges from ~80-90 percent and clinical improvement is seen in ~ 60-70% individuals.