Stroke is one of the leading causes of morbidity and mortality in developing nations like India. Timely detection and intervention is crucial in changing the outcome of the disease process.
Overview — What is Mechanical Thrombectomy?
Mechanical thrombectomy (MT) is now considered the gold-standard intervention for patients with acute ischemic stroke (within 24 hours).
Once a patient with stroke arrives at a stroke-ready hospital, a quick CT/MRI is done to detect the extent of the damaged brain areas. If eligible, the patient is advised to undergo mechanical thrombectomy.
MT is a minimally-invasive procedure done through the groin. With the help of catheters/tubes, we inject dye to localise the blocked vessel in your brain, and then pull out the clot/thrombus using aspiration or stent retrievers. The procedure is performed without opening the skull or brain.
Remember: Time is Brain.
Symptoms — Recognise a Stroke with BEFAST
Balance
Sudden imbalance or loss of coordination
Eyes
Sudden loss or blurring of vision
Face
Facial drooping or weakness on one side
Arm
Weakness in an arm or leg
Speech
Slurred speech or difficulty speaking
Time
Time is Brain — act immediately
Causes & Risk Factors
- Hypertension (high blood pressure)
- Diabetes
- Smoking
- Stress
- Sedentary lifestyle
- Cardiovascular disease (AF, RHD)
- Chronic kidney disease (CKD)
When to See a Doctor
If you notice or experience any of the symptoms listed in BEFAST, you should immediately contact the nearest stroke-ready hospital, interventional neuroradiologist, or neurologist.
Diagnosis
- Urgent CT / MRI to differentiate ischemic from hemorrhagic stroke.
- CT angio / MR angio to locate the blockage in the vessel.
- CT perfusion / MR perfusion to identify viable areas of brain.
- MRI is preferred for patients with chronic kidney disease.
- CT is preferred for claustrophobic patients.
Treatment / Procedure
For acute ischemic stroke, treatment options include:
Within 4.5 hours
Intravenous Thrombolysis (IVT)
If the patient arrives within the window period (within 4.5 hours of onset), intravenous thrombolysis can be administered.
Up to 24 hours
Mechanical Thrombectomy (MT)
If the patient is not eligible for IVT or is beyond the window period (up to 24 hours), mechanical thrombectomy is a viable option.
Conclusion
Stroke is on a rising trend in India, and a lack of awareness among the general population hinders its early detection and adequate management. If you or a relative develops any symptom included in BEFAST, rush them to the nearest stroke-ready hospital.