Mechanical thrombectomy and thrombolysis for strokes

Various treatment options

The Department of Neuroradiology offers various treatment options:

Thrombectomy

Rapid endovascular therapy is crucial for severe strokes with occlusion of large cerebral vessels. A catheter is inserted via the inguinal artery to the cerebral vessels and the blood clot is mechanically removed from the cerebral vessel.

Thrombolysis

A drug is administered that either contains enzymes itself or activates the body’s own enzymes. These break down the blood clot and can thus remove minor blockages.

Advantages and disadvantages

Advantages

• Endovascular therapy has revolutionized the treatment of severe strokes since 2015. In the case of occlusion of large cerebral vessels, this procedure is clearly superior to previous forms of therapy, e.g. dissolving the clot using medication (thrombolysis).
• Treatment can dramatically improve the neurological symptoms (paralysis, speech impairment).
• This dramatically reduces the likelihood of severe disability or death following a severe stroke.

Disadvantages

• Rarely, procedural complications may occur (cerebral hemorrhage, strokes in other regions of the brain).
• Thrombectomy is not suitable for patients who only reach the hospital 24 hours after a stroke or even later.

Procedure

Thrombectomy is an emergency treatment. A decision as to whether a thrombectomy can be performed is made within a very short time on the basis of the CT or MRI imaging. An anaesthesia team prepares the patient for the procedure in a quick, standardized process. An experienced interventional neuroradiologist from the emergency team then performs the procedure under anesthesia.

Aftercare

Immediately after the procedure, you will be examined to make sure that everything went well. You will then be transferred to a specialized monitoring ward (stroke unit), where you will be cared for and monitored.