Stroke treatments (clot retrieval for acute stroke)
What treatments can be used to treat strokes?
A stroke requires urgent diagnosis and treatment to restore blood flow to the brain.
Firstly, strokes can be treated using intravenous (IV) medications – IV thrombolysis to help break up clots in the body, after which blood thinners, also known as anticoagulant drugs, are prescribed in order to help prevent more blood clots from forming and reducing the risk of a stroke recurring.
Strokes can also be treated using neurointerventional techniques. This is a minimally invasive approach to treat conditions that occur within the vessels of the brain and spinal cord, and to remove blockages that are obstructing blood flow to the brain. Neurointerventional techniques are mainly used to treat ischemic strokes, which take place due to blockages in arteries in the form of blood clots or fat deposits leading to your brain, causing an obstruction of blood flow.
Alternatively, strokes can also be treated through neurosurgery, surgery performed on the brain and spinal cord, to drain blood from the brain resulting from a hemorrhage or repair damaged blood vessels. Neurosurgery is mainly used to treat hemorrhagic strokes, which occur when a blood vessel bursts within the brain, resulting in bleeding in the brain.
The approach used to treat a stroke depends on that type and severity of the stroke.
One of the most common types of neurointerventional stroke treatments is clot retrieval, also known as a mechanical thrombectomy.
What happens during a clot retrieval?
During a clot retrieval, your doctor will insert soft, hollow tubes known as catheters into the blocked artery with the help of X-ray. Tiny mesh tubes known as stent retrievers are then used to grab and remove any clots present in the artery.
A clot retrieval is usually done under general anesthesia. Under general anesthesia, you will be put into a sleep-like state, and you will not be able to move voluntarily or feel any pain.
What are the benefits of a clot retrieval?
Research has shown that stroke patients who undergo clot retrievals have significant less post-stroke disabilities, such as problems with swallowing (dysphagia), full or partial loss of memory and ability to speak, muscle weakness, tremors, or in serious cases, paralysis. Additionally, 48.6 percent of stroke patients who had clot retrievals were independent at 90 days after the stroke as opposed to only 13.1 percent of patients who were treated medically or with clot-busting drugs alone .
What are the possible side effects of clot retrieval?
Some of the commonly seen complications associated with clot retrieval include :
- Bleeding in the treated area pre or post-operation
- Perforation or damage to nearby vessels or nerves
- Infection at access site where catheter is inserted
- Anesthetic or contrast related
What happens after stroke treatment?
Following a stroke, long-term effects vary from person-to-person, and are dependent on the severity of the stroke and location of the brain which is affected. Patients with stroke-related disabilities may choose to go for rehabilitation or speech therapy.
After a clot retrieval, you will likely spend a few hours in the recovery room, and at the hospital for a day or more depending on your condition. Your doctor will also watch your vital signs, such as your heart rate and breathing to ensure that you are recovering well after your procedure.
If you have any questions about the types of stroke treatments, do seek clarification with your doctor and find out which treatment is suitable for you.
- Rush University Medical Center. (2017, June 6). Clinical benefit of clot retrieval now proven up to 24 hours after major ischemic stroke. ScienceDaily. https://www.sciencedaily.com/releases/2017/06/170606155725.htm
- Balami, J. S., White, P. M., McMeekin, P. J., Ford, G. A., & Buchan, A. M. (2017). Complications of endovascular treatment for acute ischemic stroke: Prevention and management. International Journal of Stroke, 13(4), 348–361. https://doi.org/10.1177/1747493017743051
- Endovascular clot retrieval for early ischaemic stroke | Deranged Physiology. (n.d.). Derangedphysiology.com. Retrieved December 21, 2020, from https://derangedphysiology.com/main/required-reading/neurology-and-neurosurgery/Chapter%201503/endovascular-clot-retrieval-early-ischaemic-stroke
- McDonald, J. S., Brinjikji, W., Rabinstein, A. A., Cloft, H. J., Lanzino, G., & Kallmes, D. F. (2015). Conscious sedation versus general anaesthesia during mechanical thrombectomy for stroke: a propensity score analysis. Journal of NeuroInterventional Surgery, 7(11), 789–794. https://doi.org/10.1136/neurintsurg-2014-011373