​Mechanical Thrombectomy Using a Stent Retriever

Until recently, there has been only one proven therapy for ischemic stroke: clot-busting drugs called tPA. Thanks to groundbreaking international research, another treatment is now available: mechanical thrombectomy with a stent retriever.

This endovascular method, researched at UPMC and other facilities worldwide, is more effective at removing large clots than tPAalone and can lead to better outcomes for stroke patients.

With the University of Pittsburgh School of Medicine, the UPMC Stroke Institute served as principal investigator in one clinical trial of stent retrieval thrombectomy and lead recruiter in another. Thanks to these trials’ success, the procedure is now approved for widespread use.

UPMC neurologists and neurosurgeons are among the most experienced in this pioneering technique, both regionally and nationally.

The Procedure, Step by Step

Before stent retrieval thrombectomy, UPMC physicians administer the clot-busting drug tPA, usually directly to the site of the clot. Learn more about tPa here.

After administering tPA, stroke physicians use advanced neuro-imaging to evaluate the patient’s brain. If tPa alone does not dissolve the clot and restore blood flow, and the patient is a good candidate, stent retrieval thrombectomy is the next step.

During the procedure, a catheter is threaded into an artery at the groin and up through the neck, until it reaches the blood clot causing the stroke.

Using x-ray guided imaging, a stent retriever is inserted into the catheter. The stent reaches past the clot, expands to stretch the walls of the artery so blood can flow, and is finally “retrieved” — pulled backwards — which removes the clot.

Advantages of Stent Retrieval Thrombectomy

Stent retrieval thrombectomy is a breakthrough in stroke treatment. Removing blood clots from the brain leads to better outcomes for stroke patients, including greater independence and mobility.

Previous endovascular interventions were unable to remove clots quickly and safely enough. When used in conjunction with tPA and medical treatments, this method significantly reduces stroke-related disability and mortality.

UPMC physicians and facilities offer expertise in acute stroke care unmatched in the region. Our specially trained neurologists and neurosurgeons have access to advanced imaging technology 24 hours a day, seven days a week at UPMC’s primary stroke centers throughout western Pennsylvania.

Stroke Resources

Stroke Institute in the news

• Study finds that surgery can lower disability in stroke patients
• UPMC research endorses breakthrough stroke treatment

Journal abstracts

• Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke
• tent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke