Thrombectomy is a procedure that can be used to treat nearly all patients who’ve experienced ischemic stroke. James Lefler, MD, board-certified neurointerventional radiologist and Richard Klucznik, MD, FACR, FSNIS, board-certified neurointerventional surgeon, at AdventHealth Tampa, share more about this innovative treatment and how AdventHealth is using it to improve outcomes for stroke patients across West Florida.
What is a Thrombectomy?
Ischemic stroke is a type of stroke caused by a blood clot that stops blood flow to parts of the brain. During a thrombectomy procedure, a doctor uses a catheter to remove the clot causing the ischemic stroke — with reassuringly low risk.
“A stroke can be described as a plumbing issue,” says Dr. Klucznik. “We can try to use a chemical — in this case, a clot-busting drug like TPA — to dissolve the clot, but if it is too big, we need to use a mechanical device to remove it. Thrombectomies are so elegant because they are a mechanical solution to a mechanical problem.”
This procedure offers a small risk with a major benefit for patients who otherwise would be completely disabled from a stroke. While TPA may not always be recommended for patients with bleeding risk, heart conditions, cancer or recent surgery, thrombectomy offers a safe alternative for stroke care.
“Thrombectomy is even safe for patients with high risk of bleeding or those who weren’t able to get TPA within the standard 4.5-hour window after a stroke,” says Dr. Klucznik. “This is the most sophisticated, effective and successful treatment we have for ischemic stroke.”
Thrombectomy Procedure
During this procedure, a specialized physician, called a neurointerventional surgeon, inserts a catheter through the groin or wrist. Once they navigate to the clot in the brain, using X-rays to guide them, they will gently remove the clot from the artery. Patients are usually under anesthesia (asleep) during this procedure.
“This procedure is invasive and requires an arterial puncture, intubation, anesthesia and more,” says Dr. Lefler. “There is risk just like any procedure, but we perform several hundred thrombectomies per year and the complication rate is surprisingly and encouragingly low.”
While thrombectomies cannot be used for strokes caused by atherosclerosis or clots too small to be retrieved, it is often the preferred treatment for large, artery-blocking clots to medium-sized clots in more distant vessels of the brain. Though this procedure is recommended within the first 24 hours after a stroke, it may be used beyond that time limit in some situations.
“This is indeed a comprehensive approach,” says Dr. Lefler. “We’ve seen a really good number of successes of patients walking out of the hospital who otherwise would be disabled or not have made it through the stroke. It’s meaningful to be able to provide this benefit to our community.”
Comprehensive Care on Standby
Treating stroke requires a collaborative approach that creates beneficial patient outcomes. In addition to facilities including an expert emergency department, state-of-the-art catheterization lab and sophisticated ICU, the team of stroke care specialists supporting thrombectomy procedures includes:
- Anesthesiologists
- Cardiologists
- Emergency medicine physicians
- Neuro-intensivists
- Neurointerventional radiologists
- Physical therapists
- Radiologists
- Vascular neurologists
These care team members work closely with referring physicians and EMS to ensure smooth transfer and ongoing care. And with a robust “pre-activation” process, the AdventHealth stroke care team can be ready to perform thrombectomies within minutes of patients arriving at the emergency room or being referred in from other hospitals. The team also debriefs every thrombectomy case after the fact to see if there are areas, they can improve to make sure they are moving as quickly and safely as possible.
From arranging transportation to reviewing imaging to setting up the catheterization lab, AdventHealth Tampa’s Comprehensive Stroke Center recognizes that “time is brain” when it comes to stroke care and doesn’t waste a minute of it.
Minutes to Treatment
Every second counts when it comes to stroke — which is why AdventHealth is ready to care for you with a full toolkit of advanced stroke care options, including thrombectomy care, delivered with speed. Learn more.
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