Often thought of as a condition affecting the elderly, stroke rates are rising in people under age 50. The silver lining is that the rate of death and serious disability from stroke seems to be declining steeply because of innovative treatment options available today that didn’t exist a decade ago.

Occlusion (blockage or closing) of brain arteries due to clots dislodging from the heart or plaque buildup in the carotid arteries can lead to ischemic stroke. In the past, treatment options have been limited primarily to clot-busting medication, such as IV-tPA (tissue plasminogen activator). However, stroke patients had to meet strict certain criteria to receive tPA treatment. Patients can be excluded from receiving IV-tPA treatment for a wide variety of reasons, including delayed arrival to the hospital, recent surgery, or taking certain blood thinners.

Mechanical Thrombectomy

Since the publication of multiple landmark stroke studies in 2015, mechanical thrombectomy has now become the gold standard for treatment of ischemic stroke caused by large artery occlusions due to its safety, efficacy, expanded treatment window, and excellent patient outcomes. As a result, more ischemic stroke patients can now be offered treatment.

The consequences of untreated large artery occlusions in the brain can be severe, including death, permanent disability, or a lifetime of dependence. Mechanical thrombectomy has been a revolutionary treatment for stroke patients. In fact, multiple studies published in the past eight years have demonstrated greater efficacy of mechanical thrombectomy versus IV-tPA alone for the treatment of ischemic stroke.

“Obviously, not all outcomes are the same, but for many patients, mechanical thrombectomy can have some of the most dramatic, immediate impacts I’ve ever seen in medicine,” said Jason J. Carroll, MD, a neurointerventional surgeon at Midwest Radiology. “We see patients going from paralyzed on one side and unable to speak, to full recovery on the table after the clot is removed.”

How it Works

Mechanical thrombectomy is an image-guided, minimally-invasive procedure in which a neurointerventional surgeon uses specialized equipment to remove a clot from a patient’s occluded brain artery. Using fluoroscopy, or continuous x-ray, the doctor guides instruments, including wires and catheters, through the patient’s arteries to the clot with the goal of removing the clot rapidly.

The nuerointerventional surgeon starts the procedure by accessing the large artery (femoral artery) in the upper part of the right leg and rarely the artery in the right wrist or arm. The doctor then threads a telescoping set of catheters through the artery to the clot.

Image Source: Penumbra, Inc.

Next, a large bore catheter is used to aspirate the clot out under high-pressure continuous suction using a special pump. Rarely, the doctors use a retrievable stent known as a stentretriever to assist in clot extraction.

The Midwest’s Most Trusted Neurointerventional Surgery Team

At Midwest Radiology, our team of subspecialty trained neurointerventional surgeons are working to improve stroke care with the latest cutting edge technology and techniques. Our team performs some of the highest volumes of mechanical thrombectomies in the United States, through our vast network of hospitals. If you or a loved one are at increased risk for stroke, make sure to know the warning signs. And, if possible, choose a medical center that offers comprehensive stroke care, including mechanical thrombectomy.