Thrombectomy, or removing a blood clot from a vessel mechanically

Obstructions in the cerebral artery are usually treated by intravenous thrombolytic therapy if the treatment can be administered within 4.5 hours from the start of the symptoms. If the largest blood vessel is blocked, thrombolytic therapy is usually not sufficient, and the artery requires a mechanical opening.
 
Thrombectomy, or, in other words, removing a blood clot mechanically, improves the patient’s likelihood of recovery. This treatment method is used when dealing with an obstruction in a large vessel, and the brain tissue affected by impaired circulation has not yet been too severely damaged.
 
Around 300 patients receive thrombolytic therapy in HUS Meilahti Tower Hospital every year. Around 260 patients undergo mechanical thrombectomy yearly. In HUS, thrombectomy treatment is available for patients 24/7. 
 
Brain damage can be prevented with swift action
 
The likelihood of saving some of the at-risk brain tissue diminishes with each passing minute. Thrombectomy is comparable to resuscitation in so that every wasted minute reduces the patient’s life expectancy by a week. Proceeding with the mechanical procedure requires collaboration between several different professionals and excellent imaging. Participating doctors include a neurologist, neuro-radiologist, interventional radiologist, and an anesthesiologist if necessary.
 
The treatment decision requires exact information about what part of the brain the obstruction is affecting and how much brain tissue is salvageable. The location of the obstruction can be identified through vascular imaging of the brain. The size of the existing damage and amount of salvageable tissue is assessed in situations where significant damage may already have developed. This is done through perfusion imaging, which measures cerebral circulation. 
 
If the lack of oxygen has already destroyed parts of the brain that are beyond the obstruction, thrombectomy cannot improve the patient's situation. Breaking down the obstruction does not repair the damage; it can only save the tissue that has survived so far with limited circulation. 
 
The location of the stroke and the time elapsed from the start of the symptoms to the start of the treatment affect the patient’s recovery prognosis and rehabilitation needs. Permanent symptoms vary greatly. Two out of three patients treated acutely at HUS recover well, and our mortality rate in cerebral strokes is the lowest in the world.