Everything You Need to Know About Endovascular Thrombectomy

When it comes to your vascular health, understanding the various treatment options available is crucial. Endovascular thrombectomy is an innovative procedure that has transformed the management of certain vascular conditions, particularly patients with deep vein thrombosis, a type of blood clot typically occurring in the veins of the leg, thigh or pelvis, sometimes traveling to the lung causing a life-threatening pulmonary embolism.

In this blog post, we will discuss the reasons why this procedure is performed, the point at which intervention is considered, along with a comprehensive overview of the pre-operative, intra-operative, and post-operative aspects of endovascular thrombectomy.

Why is Endovascular Thrombectomy (EVT) Performed?

Endovascular thrombectomy is primarily performed to remove blood clots that have formed in arteries or veins. This procedure is designed to remove the clot and restore blood flow, minimizing the potential damage the clot may cause, improving the patient's chances of recovery.

EVT is the next step when traditional clot-buster medications do not or cannot work. The procedure can be performed safely and effectively, which is important when it comes to treating or preventing a pulmonary embolism.

At What Point is Intervention Considered?

The decision for intervention is based on several factors, including the patient's clinical presentation, the size and location of the clot, the efficacy of other treatment modalities and the time since the onset of symptoms.

Time is of the essence when it comes to endovascular thrombectomy. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus (less than 10-14 days). For stroke patients, the procedure is usually most effective when performed after the onset of stroke symptoms, usually within the first six hours. However, in some cases, select patients may still benefit from the procedure up to 24 hours after symptom onset, depending on individual circumstances.

How Does the Procedure Work?

Endovascular thrombectomy is a minimally-invasive procedure that involves accessing the clot within the blood vessels and then using specialized equipment to remove it. Let's take a closer look at the different stages of this procedure:

1. Pre-operative: Before the procedure, the patient undergoes a comprehensive evaluation, including imaging tests such as a CT scan or MRI to confirm the diagnosis and identify the location and extent of the clot. The medical team will also assess the overall health and review the patient’s medical history to ensure they are a suitable candidate for EVT.
   
   
2. Intra-operative: During the procedure, the patient is placed under conscious sedation or general anesthesia to ensure their comfort. A microwire is inserted through a pinhole incision to the area of the clot where a sophisticated device is used to remove it. Guided by real-time imaging, the catheter is carefully advanced to the site of the clot. This is typically done using only local anesthesia and some sedation for comfort.  
   
   
3. Post-operative: After the procedure, you are closely monitored in a specialized recovery unit or intensive care setting. Regular imaging tests are performed to assess the reperfusion (restoration of blood flow) of the artery or vein. The medical team provides appropriate post-operative care, including managing any potential complications, such as bleeding or infection. 
   
   

Endovascular thrombectomy has recently received a lot of attention for its new application with acute ischemic stroke patients. However, The Cardiovascular Care Group has been using this procedure for our vascular patients for years, performing hundreds of EVT procedures for blood clots in the extremities as with superior success rates.

To learn more about endovascular thrombectomy procedures and the 15 board-certified vascular physicians who are trained in the latest techniques and procedures in vascular medicine, contact us today.