Heart attacks develop as a result of coronary artery disease. If changes occur in the walls of the blood vessels, it can lead to dissection, i.e., a tear in the vessel's inner wall. As a result of the tear, platelet aggregation is activated and the vessel gets blocked. Thrombectomy is a procedure in which the blood clot is removed from the blood vessel. The most common sites where it can occur are the legs, arms, intestines, brains, and heart. Thrombectomy is an interventional procedure that helps to restore blood supply to the heart.
Recently, the procedure has become significantly less invasive. In recent times, only a small incision must be made in the vessel to insert the instruments into the heart. The blood clot is then aspirated either immediately or in smaller fragments. Thrombectomy has improved the efficacy of the treatment for heart attacks.
Thrombectomy, especially coronary thrombectomy, is usually done in those patients who cannot be treated for heart diseases with medications like blood thinning agents. Although this procedure helps to prevent the blockage of blood flow to a particular organ, it can put one at risk of :
- Death
- Embolus (when a thrombus breaks from one location and lodges in another part of the body)
- Permanent damage to a tissue or organ
Patients should avoid undergoing thrombectomy in the following cases:
- If the blood clot is present in a location that is hard to reach
- A blood clot is present in a tiny coronary vessel
- Blood clots that can be treated with medications
- Having a pre-existing blood disorder
- Very high blood pressure levels
The process of removing a clot can involve one of the following two methods:
- If the blood clot is huge, a thrombectomy catheter removes a thrombus. Large clots are usually broken up into smaller pieces before being removed.
- Anticoagulants can treat the same if the blood clot is not very large.
The steps involved in the process of thrombectomy are as follows:
- A local anesthetic is applied, and a small incision is made in the artery.
- A guide wire is placed inside the artery, and a catheter is introduced into the coronary artery.
- The guide wire crosses the stenosis and breaks the clot into several pieces. The fragments are then aspirated.
- The affected section is treated using a balloon catheter and a stent.
- The balloon and catheter are removed, and a pressure bandage is applied to the entry site. The patient is then moved into the observation ward.
FAQs
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How does a thrombectomy work?
Thrombectomy involves using a specially designed clot removal device inserted through a catheter to remove the clot and restore the blood flow to the affected area.
When should one consult a doctor after undergoing a thrombectomy?
One should consult a doctor if one experiences bleeding, weakness, chest pain, breathing problems, and light-headedness. Such symptoms usually signify the presence of complications or dislodgement of the thrombus.
How effective is thrombectomy?
Sometimes thrombectomy combined with thrombolysis is used to cause clot lysis. Thrombolysis is also usually done before thrombectomy to break down the blood clot. However, thrombectomy is the preferred treatment method for people experiencing acute stroke. When it is performed within 24 hours of experiencing an acute attack, it can prevent disability. Thrombectomy should be performed within six hours of the onset of symptoms.
How long should one take bed rest after undergoing a thrombectomy?
A 12-hour bed rest is considered adequate after an acute ischemic stroke episode. However, it may be associated with reduced neurological deficit at discharge, shorter length of stay, and reduced readmission rates within 30 days.
Who is eligible for a thrombectomy?
About 10% of stroke patients are eligible for thrombectomy every year. It is usually done in those patients for whom it is a powerful intervention.
What conditions can be treated by thrombectomy?
Thrombectomy can treat conditions like pulmonary embolism, stroke, lack of blood flow to the heart, and deep venous thrombosis. It can also treat arrhythmia and atherosclerosis.
Is thrombectomy an invasive procedure?
Thrombectomy is a minimally invasive procedure. This means that the surgeon can perform surgery in a minimally operative field. It is a better method than performing an open surgery.
What are the different types of thrombectomy?
There are primarily two types of thrombectomy. Surgical thrombectomy involves making an incision on a blocked blood vessel. It cuts open a blood vessel, removes the clot using a balloon, and repairs the blood vessels. Percutaneous thrombectomy involves introducing instruments into the vessel to cause thrombolysis. Some of the techniques include:
- Catheter-induced thrombectomy, along with thrombolysis
- Catheter-directed aspiration thrombectomy
- Catheter-directed thrombolysis
Advanced Technology & Facilities
At Aster Hospitals, we perform state-of-the-art procedures to provide the best facilities to the patients so that they do not experience any disability in the future.
Coronary thrombectomy is a specialized procedure that is performed by a specialist team. Clots can occur in any part of the body. However, the ones that occur in the heart are considered life-threatening.
Although there is no assurance that everyone will recover completely after having a blood clot, the severity of the damage can be reduced by removing the clot as early as possible.
The following modalities of treatment have been recognized for the treatment of clots:
- Imaging scans to locate the exact site of the clot so that the chances of complications reduce drastically. The size and position of the clot can be determined accurately.
- Patients should be given tissue plasminogen activators to dissolve the clot before a thrombectomy quickly.
- Thrombectomy is a procedure that is necessary if a large block is present in the artery such that the efficacy of the heart is reduced.
Although it is recommended to perform the surgery within 16 hours of the patient experiencing a stroke, it can be performed after 24 hours of the onset of the stroke. Thrombectomy is a time-sensitive procedure and should be performed as soon as the patient is admitted. At Aster Hospitals, we care for our patients and provide immediate services to save lives.
