Categories: Neurology

Mechanical Thrombectomy: A change in Stroke care

Patients with brain stroke are continuously rising in India, and nearly one-fifth of patients with first-ever stroke admitted to hospital are aged 40 years or less (as per published hospital-based data). Lifestyle causes such as extreme rise in smoking, hypertension, diabetes, and dyslipidemia in the population at a younger age are predisposing them to brain stroke sooner.

Physicians use clot-busting drugs/medications to open blocked blood vessels, as the first line of defense. Five global clinical trials have shown that the addition of stent retriever therapy also known as Mechanical Thrombectomy in addition to clot-busting drugs has shown to reduce disability, improve neurological outcomes & increased the rate of return to functional independence in stroke patients.

Which patients should opt for Mechanical Thrombectomy:

  • Patients who do not recover after a 1-hour infusion of IV TPA (clot-busting drugs) should go for mechanical thrombectomy in the cath lab.
  • Clot-busting drugs can be counter-productive for patients on anticoagulants, low platelet count, recent heart attack, recent previous stroke, peptic ulcers, recent surgery, and such patients can be directly taken for mechanical thrombectomy.
  • Also, patients coming between 4.5 to 8 hours post-stroke should also opt for this line of treatment.

Mechanical Thrombectomy has emerged as a ‘game-changing’ new treatment option that restores blood flow to the brain after a stroke. The treatment, being offered at very few centers in Rajasthan & Western India can significantly improve the chances of recovery for individuals who suffer a severe form of brain stroke where blood vessels in the brain become blocked.

During the procedure, a stent retriever device through a fine catheter is inserted into a blood vessel, usually from the groin area, and travels through the arteries to the brain, where it is used to dislodge and remove the blood clot (blockage). Trials have shown that if a patient undergoes the procedure within six to eight hours of stroke symptoms beginning to show, survival rates and quality of life are dramatically improved. The cutting edge procedure is carried out by a highly trained practitioner called an Interventional Neurologist.

Mechanical Thrombectomy is a real game-changer that can save lives and reduce the chances of someone being severely disabled after a stroke. Patients immensely benefit from the thrombectomy service, with an 80 to 90 percent chance of opening blocked vessels via this technique, compared to 30 percent with traditional clot-busting drugs.

Patients with acute stroke require a range of different interventions but providing a thrombectomy service – including at all times of the day, radically improves the range and mix of interventions which is highly beneficial to patients & helps significantly reduce chances of death or life-long disability commonly associated with stroke. The new treatment is being described as “one of the top 10 medical innovations of the last decade”.

Dr. Prashant Singh, Consultant Interventional Neurology, Narayana Multispeciality Hospital, Jaipur

Narayana Health

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