Usually performed as an emergency procedure, a thrombectomy can be a lifesaving procedure to remove a blood clot in an artery or vein. The types of thrombectomy procedures vary, but they all aim to restore blood flow and minimize damage to vital organs.
A thrombectomy is a surgical procedure to remove a blood clot from an artery or vein. A blood clot (or thrombus) blocks the blood flow in blood vessels. Blood clots are most common in the brain, heart, and lungs, but they can also occur in the legs, arms, and intestines.
If not treated in a timely manner, a blood clot can cause permanent damage to vital organs or limbs. While a blood clot can sometimes be treated with medications, a thrombectomy — often an emergency procedure — is used to remove a clot and restore blood flow when other treatments don’t work.
This article will take a closer look at the different types of thrombectomy, when it’s needed, the potential risks, and what recovery is like.
A thrombectomy is a procedure to remove a blood clot, also known as a thrombus. It’s done by opening up the affected vein or artery and removing the clot.
Two general types of procedures can be used for a thrombectomy. These are:
- Surgical (open) thrombectomy: A surgeon opens a blood vessel and extracts the clot with a vacuum or catheter.
- Percutaneous (minimally invasive) thrombectomy: A surgeon uses image guidance (such as a continuous X-ray) to lead one of several types of devices to the clot. The device might suction the clot out of the blood vessels, or it could break the clot apart so the pieces can be vacuumed out.
There are many different techniques used in thrombectomies. The specific procedure will vary based on the clot size and location, your overall health, and your history of blood clots.
A thrombectomy is often an emergency procedure that’s used if other methods to treat a blood clot aren’t working.
Not all blood clots require surgical treatment. Blood-thinning medications or clot-busting prescription medications, known as thrombolytics, may be used initially. If these options aren’t successful, thrombectomy may be considered.
A thrombectomy is most commonly performed on people with an arterial embolism, which is a blood clot in an artery. Symptoms of this kind of blockage include:
- muscle pain, weakness, or both
- a tingling, numb sensation (usually in a limb)
- a cold feeling in an area
- trouble breathing
- sudden problems with vision or speech
There are several instances when a thrombectomy isn’t appropriate. These include:
- when the clot is hard to reach
- when the clot is in a very small blood vessel
- when treatment with medications will be more successful
- if you have a blood disorder
- if you have an internal bleed or a brain bleed
- if you have elevated blood pressure
A thrombectomy can be used to treat blood clots in various parts of the body. There are procedural differences and outcomes based on the location of the blood clot.
A blood clot in the brain can result in an ischemic stroke. When diagnosed promptly, thrombectomy can be
Ideally, the procedure is begun within a 6-hour window of symptom onset, though
Heart (heart attack)
A heart attack happens when blood flow is blocked in the coronary artery. Angioplasty is a common, minimally invasive procedure that can restore blood flow in the event of a heart attack.
Occasionally, a thrombectomy may be done during angioplasty to remove a large clot. With this technique, the clot would be suctioned out by way of an inserted catheter.
Thrombectomy hasn’t been shown to be superior to angioplasty for reducing coronary blockages and is usually only suggested as a backup procedure to angioplasty.
Lung (pulmonary embolism)
Blood clots in the lung (pulmonary embolism) usually happen when a clot in another part of the body moves and becomes lodged in the blood vessels of the lungs.
The most common symptom of a pulmonary embolism is either sudden or gradual shortness of breath.
A thrombectomy is used for a pulmonary embolism only in individuals whose medical conditions are considered
Deep vein thrombosis (DVT)
Deep vein thrombosis (DVT) is when a blood clot forms in a vein deep in your body. This is most common in the lower leg or thigh but can happen elsewhere as well.
DVT may be treated with thrombectomy if the clot becomes unstable, is starting to cause severe symptoms, or if medications can’t be used or are ineffective.
Thrombectomy has been shown to offer a
Abdomen (acute mesenteric ischemia)
Acute mesenteric ischemia is a sudden blood clot in the main intestinal artery that cuts off blood supply to the small intestines. This condition is a medical emergency and requires immediate surgery.
Thrombectomy for this kind of blood clot usually involves suctioning the clot out by way of a small catheter device. When used appropriately, this minimally invasive procedure can be effective but has limitations when it comes to assessing bowel viability.
The type of thrombectomy will determine the exact procedure details, but the general steps will be similar. Because a thrombectomy is most often unplanned, any advance preparation is typically eliminated.
A thrombectomy typically includes the following steps:
- Imaging exams: Before a thrombectomy, imaging tests, including X-rays, arteriograms, venograms, or CT scans, may be needed to locate the exact position and size of the blood clot.
- Intravenous (IV) fluids and medication: An IV will be started to deliver fluids and medications such as a blood thinner.
- Anesthetic: This medication will make you sleep during surgery. Sedation may be used in some cases. This means you won’t be fully asleep, but you’ll be relaxed.
- Skin prep: Depending on where the incision will be, the site may have to be shaved to remove hair. Local anesthetic may also be applied so you don’t feel the incision.
- Imaging guidance: If needed, the surgery team will set up X-ray or other imaging so the surgeon can see the blood vessels and the clot during the surgery. This lets them safely and effectively reach the clot with specific tools.
- An incision: The location where an incision is made depends on the type of thrombectomy. For a percutaneous thrombectomy, the incision site is commonly made in the groin, neck, or arm.
- Clot removal: The type of procedure you have will determine how the clot is removed. There are many types of devices that can be used to suction or vacuum out the clot. Usually, these devices are fed into an artery or vein by way of a catheter. Other devices may be used to break up the clot so it’s easier to bring out in pieces.
- Stent placement: Sometimes a stent is needed inside an artery or vein to keep it open after the clot is removed. This will be placed before closing the incision.
- Closing and cleaning: Lastly, the surgical tools will be removed, and the blood vessel is closed. The surgeon may place stitches or bandages to cover the incision site and keep it clean during healing.
Immediately after surgery, you’ll be taken into a recovery room where you’ll be monitored. Most people will need to stay at the hospital overnight or longer.
A thrombectomy does have some risks.
- tearing of the blood vessel
- excessive bleeding
- damage or narrowing of blood vessels
- severe bruises at the puncture site
- brain hemorrhage or bleeding in the brain
- reaction to anesthetic
After a thrombectomy, a doctor or healthcare professional may have you up and moving shortly after your surgery to lower the risk of other blood clots. A doctor will also prescribe a care plan to help you recover successfully. This may include:
- Medications: Anticoagulants (blood thinners) and thrombolytics (clot-busting drugs) are commonly prescribed after this surgery. These medications help break up any remaining bits of the blood clot, and they may prevent future clots.
- Compression socks: These socks or stockings can also help prevent a clot from forming again. A doctor may suggest you continue to wear them after the surgery. They support good blood flow in your limbs.
- Movement: Regular exercise can help improve circulation and lower the risk of blood clots.
Survival rates after a thrombectomy depend on several factors, including your overall health, the damage caused by the clot, and where the clot was located.
Blood clots can be life threatening. They block blood flow to vital parts of the body and can lead to long-term disability and permanent damage to tissues or organs.
A thrombectomy can help remove blood clots from a vein or artery. This procedure can restore blood flow and help prevent or minimize damage to vital organs and nearby tissue.
A thrombectomy is usually an emergency procedure, so the sooner it’s done after symptoms start, the better. Get immediate medical attention if you develop symptoms such as difficulty breathing, sudden muscle pain or weakness, or problems with speech or vision.