Endovascular Thrombectomy (EVT)
Endovascular thrombectomy, or EVT, is a minimally invasive surgical procedure used to treat acute ischemic stroke. EVT involves the removal of a blood clot from a blocked artery in the brain, which can restore blood flow and prevent further brain damage. At UF Health, or expert neurovascular surgeons have been performing EVT for strokes for decades and are at the forefront of finding ways to deliver this lifesaving treatment as soon as possible after the start of stroke symptoms.
What is endovascular thrombectomy?
Endovascular thrombectomy is a procedure that involves the insertion of a catheter (a long, thin tube) into an artery in the groin or wrist. The catheter is then guided up through the blood vessels to the site of the blocked artery in the brain. Once the catheter is in place, a small device called a stent retriever is used to capture and remove the blood clot, restoring blood flow to the affected area of the brain.
Endovascular thrombectomy is typically performed on patients who have suffered an acute ischemic stroke, which occurs when a blood clot blocks an artery in the brain. This can cause severe neurological symptoms, including weakness or paralysis on one side of the body, difficulty speaking or understanding speech, and vision problems.
Oftentimes endovascular thrombectomy and mechanical thrombectomy are used interchangeably, however, they have slightly different meanings.
Mechanical thrombectomy is a broad term used to describe procedures that involve the mechanical removal of a blood clot. This may include surgical procedures that are performed outside the blood vessels, such as a craniotomy, where the skull is opened to access the brain.
On the other hand, endovascular thrombectomy specifically refers to a minimally invasive surgical procedure that is performed within the blood vessels using a catheter and a stent retriever and often has fewer risks than open surgery.
How is endovascular thrombectomy performed?
Endovascular thrombectomy is performed by a team of specialized doctors and nurses in a hospital setting. Before the procedure, the patient will undergo a series of tests to confirm the diagnosis of an acute ischemic stroke and determine the location of the blood clot.
During the procedure, the patient will be given a local anesthetic to numb the area where the catheter is inserted. The catheter is then guided up through the blood vessels to the site of the blocked artery in the brain using X-ray imaging to help guide the catheter.
Once the catheter is in place, a stent retriever is used to capture and remove the blood clot. The stent retriever is a small device that is inserted through the catheter and expands to capture the clot. The device is then removed, along with the clot, through the catheter.
The entire procedure typically takes between one and two hours to complete, depending on the location and size of the blood clot.
What to expect before, during, and after the procedure
Before the procedure, the patient will undergo a series of tests to confirm the diagnosis of an acute ischemic stroke and determine the location of the blood clot. This may include a physical examination, blood tests, and imaging tests such as a CT or MRI scan.
During the procedure, stroke patients will be given a local anesthetic to numb the area where the catheter is inserted. The patient will be awake and able to communicate with the medical team throughout the procedure. The procedure may cause some discomfort or pressure, but it should not be painful.
After the procedure, the patient will be monitored in the hospital for several days to ensure that there are no complications. The medical team will provide instructions for recovery and rehabilitation, which may include physical therapy, occupational therapy, and speech therapy.
Why choose UF Health for endovascular surgical care?
The vascular neurosurgeons at UF Health understand that time is brain, meaning that the sooner the treatment of a stroke, the likelihood that there will be a reduction in the amount of brian damage and a better recovery. With the addition of the Mobile Stroke Treatment Unit, a specialized ambulance equipped to speed the diagnosis and treatment of stroke, UF Health is helping to limit the long-term effects of stroke for patients in Florida. By deploying this ambulance to the patient, the team can begin treatment while in transit to the nearest available stroke center, saving critical moments to reduce long-term disability from the stroke.
