Comprehensive Guide to Mechanical Thrombectomy and Thrombolysis for Acute Ischemic Stroke Management
An acute ischemic stroke occurs when a blood clot blocks blood flow to the brain, depriving it of oxygen and nutrients. This leads to brain tissue damage and neurological deficits.
Mechanical thrombectomy is a minimally invasive procedure used to remove a blood clot (thrombus) from a blocked artery in the brain.
Thrombolysis involves injecting clot-dissolving medication (tPA: tissue plasminogen activator) into the bloodstream to dissolve the clot.
Most common method.
A stent is delivered through a catheter into the blocked artery.
The stent is expanded, entangling the clot.
The clot and stent are removed together.
Uses a large-bore catheter to suction the clot directly.
Faster clot removal compared to stent retrievers.
Effective for large vessel occlusions.
Combination of stent retriever and aspiration techniques.
Increases success rates for clot removal.
Reduces procedure time.
Catheter suctions the clot without using a stent retriever.
Used for straightforward occlusions.
tPA (Alteplase) is administered through an IV line.
Most effective if given within 3–4.5 hours of symptom onset.
Thrombolytic agent is delivered directly into the blocked artery using a catheter.
Used in patients who cannot receive IV tPA or for large vessel occlusions.
IV tPA + Mechanical Thrombectomy.
Provides faster and more effective clot removal.
Ideal for large vessel occlusions.
Weakness or numbness on one side of the body.
Facial drooping or asymmetry.
Slurred or impaired speech (dysarthria).
Difficulty understanding language (aphasia).
Sudden vision loss or blurred vision.
Double vision or difficulty focusing.
Loss of balance and coordination.
Difficulty walking or standing.
Sudden, severe headache with no known cause.
May be accompanied by nausea or vomiting.
Cholesterol and fat deposits form plaques.
Clots from the heart (cardiogenic embolism) or atherosclerotic plaque fragments.
Block blood flow in cerebral arteries.
Blockage in major arteries:
Irregular heartbeat forms clots that travel to the brain.
Plaque buildup in the carotid artery.
Can break off and cause a stroke.
arotid stenting.
Low-fat, low-sodium diet.
Reduce cholesterol and blood pressure.
Increase fiber, fruits, and vegetables.
150 minutes of moderate activity weekly.
Improves cardiovascular health.
Reduces arterial damage and plaque buildup.
Improves circulation.
Blood pressure control prevents arterial damage.
Diabetes management reduces vascular complications.
Prescribed for patients with atrial fibrillation.
Reduces clot formation.
IV thrombolysis for patients with acute ischemic stroke.
Must be given within 3–4.5 hours of symptom onset.
Performed in large vessel occlusions.
Time window: 6–24 hours after symptom onset.
Procedure duration: 1–2 hours.
CT or MRI scan to confirm ischemic stroke.
CT angiography to identify the blocked artery.
Catheter inserted through the femoral artery.
Stent retriever or aspiration catheter removes the clot.
Restores blood flow.
tPA or tenecteplase is injected intravenously.
Dissolves smaller clots.
May be combined with thrombectomy for large vessel occlusions.
Hospital Stay: 2–5 days.
Full Recovery: Several weeks to months.
Post-Op Instructions:
