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Mechanical Thrombectomy for Large Vessel Occlusion Stroke

Endovascular clot retrieval for acute ischemic stroke

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Mechanical Thrombectomy for Large Vessel Occlusion Stroke?

Mechanical thrombectomy uses stent retrievers or aspiration catheters to physically extract clots from large cerebral arteries.

It is indicated for occlusions of the internal carotid artery, M1 or proximal M2 segment of the middle cerebral artery, or basilar artery.

The procedure is performed under local or general anesthesia in an interventional neuroradiology suite.

Modern guidelines extend the treatment window to 24 hours in selected patients using CT perfusion or diffusion-weighted MRI mismatch criteria (DAWN, DEFUSE-3 trials).

It is often combined with intravenous thrombolysis (alteplase or tenecteplase) when the patient meets criteria.

Successful reperfusion (TICI 2b-3) correlates with significant reduction in disability.

Symptoms

Sudden onset focal neurological deficit (hemiparesis, hemianesthesia)
Aphasia or dysarthria (dominant hemisphere involvement)
Hemineglect, gaze deviation (non-dominant hemisphere)
Acute decline in consciousness (basilar occlusion)
Severe stroke severity (NIHSS ≥6 typically required)
Symptoms developing within minutes to hours, with last known well time documented

Risk Factors

Atrial fibrillation (cardioembolic source)
Carotid artery atherosclerosis
Hypertension and diabetes mellitus
Hypercoagulable states
Prosthetic heart valves
Recent myocardial infarction or large vessel surgery

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Any sudden focal neurological deficit is a stroke emergency—call emergency services immediately.
  • Time is brain: every minute of LVO causes loss of approximately 2 million neurons.
  • Patients waking with deficits should be evaluated for thrombectomy regardless of unknown onset time.
  • Worsening neurological status during initial evaluation requires urgent escalation.
  • Posterior circulation symptoms (vertigo, ataxia, cranial nerve palsies) require basilar artery evaluation.

Treatment Methods

01
Rapid CT/CTA imaging to confirm LVO and exclude hemorrhage.
02
Advanced imaging (CT perfusion or MRI) for late-window selection.
03
Intravenous thrombolysis if eligible (within 4.5 hours, no contraindications).
04
Endovascular thrombectomy with stent retriever or contact aspiration.
05
Blood pressure management: SBP <180/105 post-procedure.
06
Stroke unit admission with continuous neurological monitoring.
07
Antiplatelet or anticoagulation initiation based on stroke etiology.
08
Early rehabilitation initiation for functional recovery.

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.