Thrombectomy: Minimally Invasive Treatment for Blood Clots

What Happens During a Thrombectomy?

Before the surgery, the surgeon will perform a detailed diagnostic evaluation to find out the size and location of the blood clot to determine the best treatment plan. The diagnostic evaluation before thrombectomy includes imaging tests like ultrasound, MRI, CT scan, venogram or arteriogram, etc. 

The surgery itself can take 1-3 hours, depending on the surgical approach. It is normally performed under general anesthesia to ease the patient’s pain and discomfort. The surgeon may use X-rays or ultrasound while directing the catheter inside the vessel.

The surgeon will make a cut above or below the blocked vessel and either pull the clot out using a balloon catheter or use the catheter to deliver clot-dissolving medicines to remove the clot. Once the clot has been dealt with, the blood vessel and incision will be closed and sutured to prevent uncontrolled blood loss.

What to Expect After a Thrombectomy?

After the thrombectomy, you will be moved to a recovery room and monitored for any signs of postoperative complications. You will probably have to stay at the hospital for 1-2 days, depending on the location of the clot and type of surgery.

You may need to take blood thinners for a while after the surgery to prevent future blood clot formation. Make sure you take care of your incision and follow your doctor’s instructions at home to ensure complete recovery.

You should start walking immediately after the surgery as it prevents future blood clot formation. You should wait at least a week before driving, and avoid strenuous activities for at least 3 weeks to avoid potential complications. Make sure you receive approval from your surgeon before exercising.

What Are the Recovery Tips a Patient Should Follow After Thrombectomy?

After thrombectomy, you should follow the given tips to aid recovery:

• Take medications as prescribed by your doctor, especially if you have vascular or systemic issues like high cholesterol, high blood pressure, diabetes, etc. You may also need to take antiplatelets or blood thinners to prevent clot formation in the future. Make sure you don’t skip any dosages or overmedicate yourself.
• Keep the incisions clean and dry. Watch out for any signs of infection like bleeding, bruising, pus drainage, severe pain, etc. Massage the incision site with an ice pack to ease postoperative inflammation.
• Wear compression stockings to keep the blood from pooling in your legs and forming a new clot, especially if you have trouble walking around.
• Keep your legs elevated while sitting or lying down. Stay active. Try for at least 30 minutes walking everyday.
• Manage your body weight through proper diet and exercise. Stay properly hydrated.
• Avoid smoking and limit your alcohol consumption.

What Are the Types of Thrombectomy?

There are two types of thrombectomy based on the surgical approach:

• Surgical/Open thrombectomy: During this procedure, the surgeon makes an incision next to the blocked blood vessel, cuts it open, and then removes the blood clot mechanically or using a balloon catheter. Once the clot is removed, the vessel and incision are closed.
• Percutaneous thrombectomy: It is a minimally invasive procedure. During this surgery, the surgeon sucks out the blood clot using a catheter to avoid damaging the blood vessel. There are 3 types of procedures under minimally invasive thrombectomy:
  • Catheter-directed mechanical thrombectomy with or without thrombolysis
  • Catheter-directed aspiration thrombectomy
  • Catheter-directed thrombolysis

What Are the Risks Associated With Thrombectomy Surgery?

Though thrombectomy surgery is usually risk-free, occasionally it can lead to complications like:

• Scarring or narrowing of the blood vessel (stenosis)
• Uncontrolled bleeding or hematoma formation
• Infection
• Pulmonary embolism
• Anesthesia-related complications
• Recurrence of blood clot formation

You should consult your vascular surgeon if you notice signs of complications like bleeding, chest pain, disorientation, dizziness, fever, numbness, pain, pus drainage, etc.