trombektomiaa

Trombektomia (thrombectomy) is a medical procedure to remove a thrombus from a blood vessel to restore blood flow. It is most commonly used to treat acute ischemic stroke caused by a large vessel occlusion, but may also be used for other clot-related conditions such as pulmonary embolism or arterial occlusions in other organs.

In acute ischemic stroke, endovascular thrombectomy involves mechanically removing the clot via a catheter inserted into the femoral or radial artery and guided to the brain. The devices include stent retrievers and aspiration catheters; sometimes combined approaches are used. The procedure is typically performed in a specialized center by interventional neuroradiologists or interventional cardiologists, often with sedation or general anesthesia. Candidate selection relies on brain imaging that confirms a large vessel occlusion and tissue that is likely salvageable. In the early 2010s, randomized trials established benefit for thrombectomy within 6 hours of symptom onset for selected patients with anterior circulation occlusions. In 2020–2023, guidelines extended the time window up to 24 hours for selected patients using perfusion imaging criteria (e.g., DAWN, DEFUSE 3).

Outside stroke, catheter-directed thrombectomy can be used for pulmonary embolism with hemodynamic compromise or for other arterial or venous occlusions in specialized settings. Risks include bleeding, vessel injury, stroke progression, and contrast-related complications. Outcomes are influenced by time to treatment, occlusion site, and brain tissue viability; successful reperfusion is associated with improved functional recovery.