Thrombectomy is an operation in which a blood clot is removed from a blood vessel. It is mainly used for severe strokes, but also for heart attacks. It is used less frequently for blocked leg veins. A thrombectomy is a catheter procedure. This is a thin tube that is inserted into the blood vessel and then pulls the thrombus out of the vessel using a balloon.
Find out more about the procedure for this operation here and find selected specialists for a thrombectomy.
Injury to blood vessels of any kind activates blood clotting. The blood clots and forms small clots. They attach themselves to the inside of the vascular injury and seal it in this way. Blood clotting is therefore essential for wound healing.
Sometimes blood clots without an injury. This can lead to further problems.
First, a tiny blood clot forms. The body can usually dissolve this again. If it fails to do so, the blood clot can continue to grow. If it is large enough, it can block the entire blood vessel.
If this happens in a vein, it is called a thrombosis; in arteries it is called a thrombotic occlusion.
Ultimately, there are three main causes of thrombosis:
These three reasons are also known as Virchow's triad. Virchow was a German pathologist who worked intensively on normal and pathological blood coagulation.
Other examples from everyday clinical practice that are associated with clot formation:
Other risk factors are
Depending on where a blood clot is located, it can cause different problems. They can even be life-threatening in some cases, such as blood clots in
If a thrombosis is detected in time, it can usually be dissolved by administering special medication. If this is not possible, a thrombectomy, i.e. surgical removal of the thrombus, can be life-saving.
A thrombectomy is primarily considered as emergency treatment in the event of a severe stroke or heart attack. These situations are life-threatening for the patient and must be treated quickly. This means that the blocked vessels must be reopened as quickly as possible so that the brain or heart does not die.
During a thrombectomy, the thrombus, i.e. the blood clot, is mechanically removed from the vessel.
This is particularly the case with very large blood clots from about one centimeter in length. Thrombectomy is used particularly frequently in the event of a stroke, especially in younger patients or in particularly severe cases. Rapid restoration of the necessary blood flow can prevent serious disability and death.
However, whether thrombectomy is likely to be successful must be assessed on an individual basis. For example, the treatment period is crucial: the operation must be performed within a few hours of the heart attack or stroke in order to prevent permanent damage. In addition, the area of the brain or heart that has already been damaged must not be too large.
Under certain circumstances, thrombectomy can also be used for a blocked leg vein.
During a thrombectomy, a very thin catheter is inserted into the affected blood vessel from the groin or arm. The doctor then punctures the blood clot with the catheter. There is an inflatable balloon at the tip of the catheter. When the catheter is withdrawn, this balloon can be inflated and thus pull the clot along with it.
This allows the blood to flow freely again and supply the affected areas of the body with oxygen.
Thrombectomy is usually performed under general anesthesia, sometimes also under local anesthesia.
The procedure is a routine operation for some specialist areas. Vascular surgeons in particular perform it very frequently in the area of the arteries of the arm and leg.
In the area of the arteries supplying the brain, however, this procedure is an acute measure. It is only carried out in specialized clinics (usually university hospitals).
Theprerequisite for successful treatment is that specialists are available around the clock for
are available around the clock. This method has become increasingly popular in recent years, particularly in stroke treatment. As a result, many patients can be referred to specialist neuroradiology clinics and departments where thrombectomy can be performed.
There are hardly any serious risks associated with thrombectomy. In rare cases, a vessel may be injured or a clot may be displaced in the body. However, the consequences are hardly noticeable for the patient and can usually be remedied immediately.
However, if blood seeps through an injured vessel into the surrounding brain tissue, there is a risk of additional damage.
Of course, there are also certain risks associated with anesthesia and the procedure itself, but in the case of life-threatening vascular occlusions, the medical benefits always outweigh the risks.
After a successful thrombectomy, the symptoms of a heart attack or stroke often disappear very quickly.
However, further treatment of the existing consequences is still necessary. The administration of special medication should reduce the risk of renewed clot formation as far as possible.
Doctors decide which forms of therapy, medication and follow-up treatment are necessary in each individual case.
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