thrombectomie

Thrombectomie, or thrombectomy, is a medical procedure to remove a thrombus from a blood vessel and restore blood flow. It can be performed surgically or, more commonly, endovascularly via a catheter. Endovascular thrombectomy uses catheters introduced through the femoral or radial artery to reach the occluded vessel. The thrombus is then removed by mechanical devices such as stent retrievers or by aspiration, sometimes in combination. In acute ischemic stroke, mechanical thrombectomy is indicated for selected patients with large vessel occlusion within a defined time window and favorable imaging; it is performed under anesthesia with continuous neuro monitoring. In pulmonary embolism, catheter-based thrombectomy is considered for patients with contraindications to thrombolysis or life-threatening instability, and can involve aspiration or fragmentation devices. Catheter-directed techniques are also used for peripheral veins and for deep vein thrombosis, sometimes in combination with local thrombolysis.

Outcomes: rapid restoration of perfusion improves functional recovery in stroke; in PE, can rapidly reduce clot burden and improve hemodynamics. Risks include bleeding, vessel injury, distal embolization, contrast nephropathy, infection, and radiation exposure; not all patients are eligible due to anatomy or comorbidity. Availability: requires specialized neurointerventional radiology or cardiovascular teams and imaging facilities.

History: modern endovascular thrombectomy gained strong evidence in the 2010s for acute ischemic stroke, becoming standard of care in many guidelines.