A catheter to retrieve blood clots, Treatment for ischemic stroke patients
Center : Neurology Center
Article by : Dr. Chanwit Ankrohwittaya
Patients with symptoms of ischemic stroke and embolism If they arrive in the hospital within the first 4.5 hours, they will be treated with thrombolytic injection, which can reduce disability and risk of death. For patients who arrive late to the hospital that they cannot give blood clot-dissolving drugs. There is yet another innovative treatment that can save lives. "Blood clot catheterization" (Clot Retrieval).
A treatment of ischemic stroke and thromboembolism. This procedure involves inserting a catheter into the aorta with a stent in the groin to the point of obstruction. Then extract the clot from the blocked artery to open the artery without major surgery. This helps normalize blood flow to the brain again. Giving the brain a chance to recover and get back to work. This good for patients with thromboembolism where in thrombolytic drugs are ineffective or is more than 4.5 hours, in which blood clot catheter can be extended up to 6 hours after symptoms or up to 24 hours in some patients that the doctor has considered to have a chance of success. Catheterization method for ischemic stroke patients with ischemic stroke, is considered a highly effective treatment for opening blocked arteries up to 80%, reducing post-treatment complications. Reduce the chance of paralysis, and the patient responds well to treatment and improves symptoms to normal.
When to use a blood clot catheter?
For patients who arrived at the hospital later than the required time of at least 4.5 hours and has been examined with a computed tomography (CT) or an electromagnetic imaging (MRI) and finds a clot or blockage, and still within the criteria that can still be treated with this method. Patients being treated with intravenous thrombolytic drugs and does not show any improvement or still has symptoms. Doctors may consider that a catheter can be used to retrieve blood clots. Patients have some contraindications to the thrombolytic drug. or have an abnormal blood clotting condition.
The procedure for inserting a catheter to drag blood clots into cerebrovascular vessels.
- The patient must be given anesthesia or general anesthesia.
- Clean the skin around the groin.
- Cut the skin around the groin It is a small incision, about 3-4 mm for catheter insertion.
- The doctor will insert a catheter into the aorta in the groin, until the area where the blood clot blocks the blood vessels in the brain, by relying on x-ray to guide the position.
- The doctor will then place a small special stent through the catheter up to the location of the blood clot. And then release the coil gradually It is spread out in the form of a vascular sieve to cling to the blood clot and slowly take it out through the catheter.
- Pull the catheter from the patient's body through the groin.
- When doctors take blood clots the coil and catheter have been removed from the patient. The nurse will press the groin to stop the bleeding for 10-15 minutes while the patient is lying down on the bed. Do not bend the side of the catheter insertion for 8-12 hours (at the doctor's discretion).
- The patient must lie down in the intensive care unit, to observe the symptoms in which doctors and nurses will observe symptoms of brain changes. Brain hemorrhage close examination of vital signs 24 hours a day. If assessed that the patient is safe. The doctor will therefore be allowed to move him and recuperate at a normal ward.
After treatment, the patient will receive rehabilitation and neurological system through physical therapy. In order to be able to return to life as close as possible the results will vary from patient to patient.