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Definition
Thrombectomy refers to the removal of a blood clot from a blood vessel. Historically, this procedure required surgery. Currently, most mechanical thrombectomy procedures are performed percutaneously, by puncturing the skin and blood vessel using a catheter with a mechanical device on the end of the catheter used to break up or retrieve and remove the thrombus.
Current Knowledge
Removal of the thrombus is used to restore circulation to the affected tissue. Anticoagulant therapy or thrombolytic therapy using tissue plasminogen activator is usually given before the procedure. An angiogram is done prior to the procedure to locate and visualize the thrombus.
Of note, very recent evidence demonstrates that mechanical thrombectomy with clot retrieval and removal is now considered standard of care for select patients with ischemic stroke caused by some carotid artery occlusion, particularly if the occlusion is in a proximal...
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References
Albers, G. W., Marks, M. P., Kemp, S., Christensen, S., Tsai, J., et al. (2018). Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1713973.
Goyal, M., Menon, B. K., van Zwam, W. H., et al. (2016). Endovascular thrombectomy after large-vessel ischaemic stroke: A metaanalysis of individual patient data from five randomised trials. Lancet, 387, 1723–1731.
Noqueira, R. G., Jadhav, A. P., Haussen, D. C., Bonafe, A., Budzik, R. F., et al. (2018). Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. New England Journal of Medicine, 378, 11–21.
Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., Jauch, E. C., Kidwell, C. S., Leslie-Mazwi, T. M., Ovbiagele, B., Scott, P. A., Sheth, K. N., Southerland, A. M., Summers, D. V., Tirschwell, D. L., & on behalf of the American Heart Association Stroke Council. (2018). Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018, 49, eXXX–eXXX. https://doi.org/10.1161/STR.0000000000000158.
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Roth, E.J. (2018). Thrombectomy. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_9278-1
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DOI: https://doi.org/10.1007/978-3-319-56782-2_9278-1
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