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A thrombectomy is an invasive medical procedure that implies removing the blood clot from within the coronary artery, in patients who have suffered a heart attack.

"Thrombus" is the medical term used to describe a blood clot, which makes thrombectomy a procedure to remove blood clots. People who have suffered a heart attack are likely to require such a procedure because blood clots prevent blood from flowing to the heart. A thrombectomy is not to be mistaken for thrombolytic ("clot-buster") therapy, as these two procedures are very different.

Why thrombectomy?

Thrombectomy is a procedure in which blood clots are removed with the help of image guidance. It used to be a very invasive procedure, but it can now be done with a very small incision in the blood vessel, so that the specialized instruments can be inserted to remove the blood clot. This type of procedure is performed in order to remove a blockage from the coronary artery, which allows free blood flow to the heart, preventing any further heart muscle damage.

Back in 1912, it was discovered that the main cause of a heart attack is thrombosis, which is characterized by a tear in the inner lining of the coronary artery walls. In the 1980s, thrombolytic therapy and antiplatelet therapy became a part of procedures to treat heart attacks.

A thrombectomy is used to treat the recanalization of chronic thrombotic occlusion, non-ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction.

Removing blood clots is very important and urgent, because blood clots can otherwise lead to tissue death, heart-function loss, muscle pain, enlarged veins, limb pain, or a cold feeling in the chest.

What happens during a thrombectomy?

By making a small incision, the doctor will insert a catheter into your vessel network, all the way to the coronary arteries. When the catheter is in place, the doctor will push a thin wire out of it. The tip of the wire is directed to the peripheral section of the artery, to make sure that the vessel and the catheter are stably connected to one another.

To remove the blood clot, doctors will choose one of two methods:

  • When the blood clot is very large, it’s possible for doctors to break it up into smaller pieces. Each piece is individually removed.
  • If the blood clot is small to medium in size, doctors can choose smaller catheters to suction the blood clots using additional tubes.

The procedure starts with a local anesthetic administration, plus a small artery incision. Once the blood clot is completely or partially removed, the procedure continues with a balloon catheterization and most likely a stent placement.

There are two types of thrombectomy:

  • Catheter aspiration thrombectomy, which involves sucking out the blood clot from the coronary artery.
  • Mechanical thrombectomy, which implies breaking up the clot in smaller pieces prior to removing them.

Risks of a thrombectomy

The risks of a thrombectomy are minor, but that doesn’t make them not worth mentioning. One of the most common risks is bruising at the puncture site. Since the procedure involves the insertion of an instrument all the way to the blood clot, it’s common for people to experience skin bruising, but this is goes away quite rapidly.

Another potential risk of a thrombectomy is the advancement of the blood clot deeper into the vessel. This normally occurs in the steps that involve drug treatment. In very rare cases, some people may experience bleeding in the skull as a result of this procedure and the medical treatment that comes together with it. In these cases, doctors will stop the treatment immediately.

Benefits of a thrombectomy

A thrombectomy has very few risks. When the procedure is successful, blood flow to the heart is restored and, when performed in a timely manner, can prevent severe damage to the heart’s muscle. Ultimately, a thrombectomy that removes a blood clot can prevent heart failure due to repeated heart attacks.

One of the major benefits of a thrombectomy is the fact that medicine has evolved to a point where this procedure isn’t as invasive as it used to be. Furthermore, it’s one of the fastest ways to rid a coronary artery of a blood clot. A thrombectomy is successfully combined with other types of treatment, such as thrombolytic therapy, in order to eliminate as much of the problematic blood clot as possible from the coronary artery.

A thrombectomy is also a cost-effective solution to remove a blood clot, because it involves less days spent in the bed, but also less money spent with social care facilities over a longer period of time. A successful mechanical thrombectomy can save a patient from ending up with a life-changing disability. The procedure in itself is pretty fast, as any trained medical expert can perform it within a time frame of one hour.

Conclusion

A thrombectomy is an invasive medical procedure that implied removing the blood clot from within the coronary artery, in patients that who suffered a heart attack. Despite that, medical and technological advancements have made it possible for a thrombectomy to be performed with a very small incision in the vessel.

The procedure is quite simple, involving a few easy steps, and carries a low potential of complications. A thrombectomy is often the best method to partially or completely remove a blood clot from the vessel network, but it’s typically followed by medical treatment to eliminate the residue.

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