If you know anyone who has suffered from a stroke, you might be aware of one of the more common treatments for stroke: the clot-busting drug called tPA. This treatment works by dissolving the blood clot and improving blood flow to the part of the brain being deprived of blood. While this has been the “gold standard” for stroke treatment for decades, a new treatment is proving more effective at removing large clots than tPA alone and can lead to better outcomes for stroke patients.
The method, known as mechanical thrombectomy with a stent retriever, was researched at UPMC and other facilities worldwide. In fact, the University of Pittsburgh School of Medicine, in partnership with the UPMC Stroke Institute, served as principal investigator in one clinical trial of stent retrieval thrombectomy and lead recruiter in another. Thanks to these trials’ success, the procedure is now approved for widespread use throughout the world.
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How the Mechanical Thrombectomy Procedure Works
When a stroke patient arrives for treatment, tPA is usually delivered directly to the site of the clot. After administering tPA, stroke physicians use advanced neuro-imaging to evaluate the patient’s brain. If tPa alone does not dissolve the clot and restore blood flow, and the patient is a good candidate, mechanical thrombectomy is the next step.
During the mechanical thrombectomy:
- A catheter is threaded into an artery in the groin and up through the neck, until it reaches the blood clot causing the stroke
- Using x-ray guided imaging, a stent retriever is inserted into the catheter
- The stent reaches past the clot, expands to stretch the walls of the artery so blood can flow, and is “retrieved” – or pulled backwards – which removes the clot
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Benefits and Advantages of Mechanical Thrombectomy
Mechanical thrombectomy is considered a breakthrough in stroke treatment. Removing blood clots from the brain leads to better outcomes for stroke patients, including greater independence and mobility. Previous endovascular interventions were unable to remove clots quickly and safely enough. When used in conjunction with tPA and medical treatments, this method significantly reduces stroke-related disability and mortality.
To learn more about stroke prevention, treatment, and rehabilitation, contact the UPMC Stroke Institute to schedule an appointment or ask a question at 412-232-8840.
The UPMC Department of Neurosurgery is the largest academic neurosurgical provider in the United States. We perform more than 11,000 procedures each year. We treat conditions of the brain, skull base, spine, and nerves, including the most complex disorders. Whether your condition requires surgery or not, we strive to provide the most advanced, complete care possible. Our surgeons are developing new techniques and tools, including minimally invasive treatments. U.S. News & World Report ranks neurology and neurosurgery at UPMC Presbyterian Shadyside as among the best in the country. We also rank among the top neurosurgery departments in the U.S. for National Institutes of Health funding, a benchmark in research excellence.