Learn more about mechanical embolectomy

Posted on 25 September 2012

Dr Mark Abelson, cardiologist at Mediclinic Vergelegen’s Heart Unit, is highly skilled in cardiac catheterisation in the coronary, carotid and stroke fields. He pioneered the use of mechanical embolectomy in South Africa after travelling to the United States to learn the procedure.

Does a person who has suffered a stroke face paralysis and speech impediments?
In my last post discussing strokes I explained that strokes are caused by either a blood clot, or a ruptured artery or blood vessel, which disrupts the flow of blood to the brain. Because the brain is then deprived of oxygen and nutrients, the subsequent damage can result in difficulties with movement, speech and memory. But the good news is that there is now a groundbreaking procedure, a mechanical embolectomy, which can clear the clot within a window period of eight or sometimes more hours. Thanks to this ingenious little stent-like device, a victim of a stroke, if caught in time, can go on to live a normal life.

Can any stroke victim be treated through a mechanical embolectomy?
Time is vital. This procedure can only be effectively performed as soon as possible after the onset of stroke symptoms. This is only used for the treatment of major strokes, and not if the clot is too small. Unfortunately at this time this procedure is only offered at very few hospitals in South Africa and only at Vergelegen Mediclinic in the Western Cape.

What happens during a mechanical embolectomy?
The stent-like device is essentially used to clear the clot and open the artery. Here’s what happens:
• The patient is taken to the emergency unit for the stroke to be clinically diagnosed.
• A brain scan is done to determine area and extent of the stroke.
• A local anaesthetic (in most cases) is applied to the groin area and your head is secured with sticking plaster.
• A micro-catheter containing the stent-like tool is threaded via the large femoral artery into your aorta and then into the carotid artery to the brain.
• When the stent reaches the clot it is opened into the clot, which attaches itself to the stent, and then the clot is carefully drawn out of your body, much like a cork from a wine bottle.
• Once the clot is removed the patient is admitted to ICU (Intensive Care Unit) for observation.

Why is it so important to react quickly to a stroke?
From the onset of stroke symptoms, when an area of the brain is deprived of the flow of blood, brain cells start dying, and so speed is vital to limiting damage. It’s very important to recognize the possible symptoms of strokes and to get help fast. In my last log I’d listed stroke symptoms:
• Sudden weakness or numbness of the face, arm and leg on one side of the body
• Trouble talking or understanding speech
• Dimness, blurring or loss of vision, particularly in one eye
• Unexplained dizziness, difficulty walking or sudden falls
• Confusion

If you have any questions, post them here and we’ll have them answered for you. 

Published in Cardiology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

Post a comment

Leave a reply