Thrombectomy

What is thrombectomy?

A thrombectomy is a surgical procedure to remove a blood clot from a vein or artery.

A blood clot restricts the normal flow of blood through the veins and arteries.

A thrombectomy restores the flow of blood to the brain, kidneys, and other vital organs.

A thrombectomy is an emergency procedure that, when performed promptly, minimizes the risk of permanent disability or death.

During a thrombectomy, the surgeon makes an incision into a vein or artery. This permits the removal of the clot and repair of the affected blood vessels.

After surgery, the flow of blood in the affected blood vessels is restored.

Sometimes, the surgeon can insert a balloon into the affected blood vessels to keep it open.

Why would you need a thrombectomy?

If you have a blood clot that cannot be treated with clot-busting drugs or blood thinners, you require a thrombectomy.

This surgical procedure is useful in case the clot restricts the flow of blood to vital organs hence increasing your risk for:

• Pulmonary embolus – This happens after a thrombus moves from one location to another

• Death

• Permanent organ or tissue damage

If you have the following conditions, you may not it may not be a good idea for you to undergo a thrombectomy:

• In case the blood clot is situated in a difficult-to-reach location

• If the blood vessels that are affected are too small

• If you have underlying blood disorders

• If you have elevated blood pressure that is resistant to apartment

• In case your doctor has established that the blood clot can be treated with medication

• If you have intracranial hemorrhage

• In case the clot is older than 30 days that is a chronic clot

A thrombectomy treats the following conditions:

• Myocardial infarction

• Deep vein thrombosis (DVT)

• Pulmonary embolism

• Stroke

• Renal artery occlusion

What are the signs that you require a thrombectomy?

The following signs of blood clot are a sign that you may need a thrombectomy:

• Enlarged veins

• The affected limb is painful and has a swelling or a tingling sensation to it

• The affected region feels cold or painful

• Experience a loss of sensation in the limb that is affected

Types of thrombectomies

A thrombectomy can be performed in one of two procedures:

Open thrombectomy

Here, the surgeon uses a catheter or vacuum to open a blood vessel and remove the clot.

In open thrombectomy, the blood clot is removed via a balloon catheter or mechanically.

After removing the blood clot, your surgeon will close the blood vessels and incision.

Minimally invasive thrombectomy

The procedure is also known as percutaneous thrombectomy. The surgeon uses a catheter to suck out the blood clots.

The aim of this minimally invasive procedure is to ensure there is no damage to the blood vessels.

Minimally invasive thrombectomy entails three procedures:

• Catheter-directed aspiration thrombectomy

• Catheter-directed mechanical thrombectomy

• Catheter-directed thrombolysis

The particular procedure for a thrombectomy differs from one patient to another, depending on the location, and size of the blood clots.

A thrombectomy is also determined by whether you have had a prior history of blood clots.

A person’s overall health, such as having a preexisting health condition will also influence the technique for a thrombectomy.

Preparing for a thrombectomy

The actual procedure details for a thrombectomy depend on the type of thrombectomy chosen. However, the general steps are the same.

A thrombectomy is often an emergency procedure and there is no room for preparation in advance.

In case of a planned thrombectomy, your healthcare provider will request you to:

Undertake imaging exams – These tests include MRI, CT scan, and ultrasound. These imaging exams are important in assisting your healthcare provider in planning for your surgery.

The scans create in-depth images of the location and size of your blood vessels and blood clots that require repairing.

Smoking cessation – Your healthcare provider will ask you to stop smoking as this can bring about complications during surgery.

Ask your doctor whether they have in place a smoking cessation plan to help you overcome the habit.

Medication – If you are on any prescription drugs, or are taking herbal and vitamin

supplements, let your healthcare provider know of this.

If you are taking aspirin or other over-the-counter medication, let your doctor know

about it as well.

You may have to pause taking certain drugs such as anticoagulants for a specific period before the surgical procedure.

During a thrombectomy

A thrombectomy procedure differs based on the thrombectomy you are having. The procedure takes 1 hour or several hours.

The duration of a thrombectomy is determined by the location of the blood clot and its size.

A thrombectomy entails the following procedure:

Sedation

An anesthetist will administer sedation or general anesthesia via a vein in your arm. This will keep you relaxed during thrombectomy.

Incision

Your surgeon will identify the blocked blood vessels. He or she will make an incision in the skin.

The incision can be just below or above the blood vessel that has a clot, Thereafter, the surgeon will cut open the blood vessels and remove the clot.

Catheterization

In the case of a minimally invasive thrombectomy, the surgeon punctures the blood vessels beneath or above the clot. This is often the blood vessels in your arm or leg.

Your surgeon will then insert catheters and wires into the blood vessels via the punctured blood vessel.

The surgeon operates with the help of continuous imaging scans to guide the wires and catheters into the blood vessels and hence aid in clot removal.

Clot removal

If you are undergoing an open thrombectomy, your surgeon will rely on a balloon catheter to remove the clot.

For a mechanical thrombectomy, there are special devices that help the surgeon break up or dissolve the clot. The clot is removed via a catheter-like vacuum.

Stent placement

A stent may be required inside a vein or artery. Such a stent ensures the blood vessels being repaired remain open following the clot removal.

Stent placement is done before closing the incision.

Closure

The final stage of a thrombectomy is closing the blood vessels and incisions. In case of a minimally invasive thrombectomy, your surgeon removes the catheter and wire from blood vessels.

To close the blood vessels, the surgeon may opt to hold pressure. Alternatively, he or she may decide to use a vascular closure device to assist with closing the blood vessels.

The incision site is covered using bandages or stitches so that it remains clean as you heal.

After a thrombectomy

After a thrombectomy, you will be wheeled to a recovery room. The surgical team will continuously monitor your progress in the recovery room.

Your doctor will ask that you remain in the hospital overnight or for a little longer before being discharged.

The duration of stay in the hospital is determined by the type of surgery that you underwent and the location of the clot.

You will receive detailed instructions from your healthcare provider on:

• The kind of activities to avoid while recovering at home

• If there is any medication that you will need to take or avoid, this will be mentioned to you

• You will be advised on how best to take care of the incision

• When you can resume your daily activities

Recovery after a thrombectomy

Your healthcare provider may advise you to start moving about immediately after a thrombectomy. This is important as it minimizes the risk of new blood clots developing.

Your healthcare provider will also advise you on the best care plan that can speed up your recovery. Such a care plan may entail:

• Compression stockings – These stockings are useful as they avoid the formation of a clot. If you were wearing compression stockings before a thrombectomy, your surgeon may recommend that you continue wearing them post-surgery as they promote good blood flow
• Movement – You will be advised to engage in regular exercises such as brisk walking. This increases blood circulation and reduces the risk of blood clot formation. Your surgeon will arrange follow-up appointments after you are discharged from hospital. Such appointments allow your surgeon to check on your progress.

If you experience any of the following while recovering at home, call your doctor immediately:

• Fever

• Pain or swelling that gets severe with time

• Bleeding

• In case the surgery area feels painful, numb, or weak

• If the incision leaks fluid

• Shortness of breath

• Chest pain

• Balance problems or dizziness

Benefits of a thrombectomy

A thrombectomy helps to resolve many of the problems caused by a blood clot including:

• Pain, numbness, and swelling of the affected tissue

• Death of tissue

• Affected organ dysfunctionality

Risks/complications

A thrombectomy comes with its fair share of risks for a patient. Some risks associated with this procedure include:

• Excessive bleeding

• Narrowed or damaged blood vessels

• Severe bruises (hematomas)

• Pulmonary embolism – This occurs when a blood clot travels from its original site to the lungs

• The treated blood clot might recur

• Reaction to anesthesia

Cost of Thrombectomy in India

The cost of a thrombectomy in India ranges from Rs. 100,000 to Rs. 2,50,000. This arbitrary cost is determined by various treatment and patient-related factors. These include:

• Type of surgery – That is, whether it is open thrombectomy or minimally invasive thrombectomy

• Surgeon’s fees – Highly experienced surgeons are likely to charge more for a thrombectomy

• Type of anesthesia

• Type of blockage

• The patient’s overall health condition

• The blocked blood vessels

• Diagnostic test ordered

• Patient’s age

• The room was chosen for recovery

• The city where the healthcare facility is located

• Type of hospital where thrombectomy takes place

Why choose India for a thrombectomy?

Indian hospitals offer world-class thrombectomy treatment for patients across the world.

India is a healthcare destination for thousands of international patients seeking thrombectomy treatment for the following reasons:

• Cutting-edge technology – Indian hospitals are equipped with state-of-the-art equipment to perform thrombectomy procedures
• Experienced specialists – There are many expert doctors who specialize in thrombectomy, performing open and minimally invasive thrombectomy
• Clinical excellence – Indian healthcare facilities offer efficient healthcare services to international patients
• Affordable treatment – The cost of a thrombectomy in India is only a fraction of what you would incur in another country such as the United States
• Post-surgical care – Healthcare facilities in India that specialize in thrombectomy provide follow-up instructions and consultations for their international patients, including tips on nutrition and exercise. This promotes a smooth recovery.

References

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