Have you just had an acute ischemic stroke caused by a large vessel occlusion in the brain. Or have a severe case of blood clots in other areas like the legs (DVT), lungs (PE), or heart.
And all the clot-dissolving medications (thrombolytics) are ineffective or contraindicated.
Now your doctor has recommended a thrombectomy surgery primarily to help treat an acute ischemic stroke or blood clots.
Are you having questions about how the procedure is done and what to expect? Here in interventional radiology, I see these procedures being done occasionally.
For this article I will rely on my knowledge as a diagnostic radiographer and of course on research studies on the subject matter.
Happy reading!😀 and feel free to ask questions in the comments or share your own experience.🙏
Last updated: January ,2026. Written by Juliet Semakula, a diagnostic radiographer.
| Normally, blood flows freely through your blood vessels, arteries, and veins. Your arteries carry blood with oxygen and nutrients to your body. Your veins carry waste products around the body to be removed and then deliver blood low in oxygen back to the heart. In some cases, the blood thickens and clumps to form a blood clot in one of these vessels. This can block the blood flow. When blood flow is blocked, nearby tissues can be damaged. So, a surgical thrombectomy is a type of surgery to remove a blood clot from inside an artery or vein. |
▶️What exactly is a thrombectomy?
Thrombectomy is a medical procedure used to remove a blood clot (thrombus) from a blood vessel.
It is often used to treat strokes caused by large artery blockages (Mathews,2023)
X-ray image showing selective left internal carotid angiography revealed the embolus (arrow) in the M2 segment of the left middle cerebral artery. (b) After retrieval of the embolic material, the left middle cerebral artery and end branches were completely revascularized ( image source Mathews,2023)
I have seen patients with ischemic strokes being treated with thrombectomy.
When a large artery in the brain is blocked, a thrombectomy can quickly restore blood flow to the brain, reducing brain damage and the risk of serious disability.
Other conditions such as pulmonary embolism. can be treated by thrombectomy.
Though its use in treating pulmonary embolism remains under investigation, pivotal clinical trials have provided evidence to the safety and efficacy of mechanical thrombectomy in some patients (Mathews,2023)
▶️Why might you need a surgical thrombectomy?
The blood clot can lead to many possible problems such as:
🔴Swelling, pain, numbness, or tingling in an arm or leg
🔴A cold feeling in the area
🔴Muscle pain in the area
🔴Loss of function of an organ.
🔴Enlarged veins (post -thrombotic syndrome)
🔴Death of tissue.
▶️How long after a stroke can a thrombectomy be done?
The decision is made on a case-by-case basis, depending on the location and size of the clot, the amount of brain tissue at risk, and your overall condition, remember every patient is different.
Note: Surgery is not the only kind of treatment for a blood clot. Most people with blood clots are treated with medicines called blood thinners. These are given as a pill, a shot (injection), or through an IV.
They can prevent a blood clot from getting larger. Other medicines used to dissolve large blood clots causing severe symptoms are called thrombolytics.
But if your medical team decides for you to have a thrombectomy procedure they will base on:
Different things which will influence the timing.
1️⃣The type of stroke you have got.
2️⃣Imaging results, if the CT head shows a large clot and if there is still salvageable rain tissue that can benefit from the procedure.
3️⃣Your medical records, health and medical guidelines.
Timing for a thrombectomy
🟠 I have seen a thrombectomy being performed up to 24 hours after a stroke based on imaging that shows salvageable brain tissue.
🟠Most patients are treated within 6 hours of symptoms onset, and this is considered the most effective window.
🟠Some guidelines suggest that a thrombectomy can still be beneficial up to 12 hours after the onset of symptoms.
▶️How is a thrombectomy surgery done?
Your medical team will explain the procedure to you if you are responsive and these steps will be taken during the procedure.
🔀A radiographer normally does a CT or MRI scan to locate the clot; this helps in planning the procedure.
🔀The area for the incision, usually in the groin or wrist, is cleaned and may be shaved.
🔀Local anaesthetic is administered to help numb the area so that you may not feel pain.
🔀Then a small insertion is made, and a needle is inserted to access a blood vessel.
🔀A thin, flexible wire is threaded through the needle and into the artery.
🔀The needle is removed, and a catheter (a thin plastic tube) is advanced over the guide wire to the site of the clot.
🔀Here as a radiographer, I provide guided real-time X-ray imaging allowing the surgeon to see how the clot is removed.
X-ray image showing Interventional stroke management with cannulation of the ostium of the left common carotid artery (arrow), through the interstices of the uncovered nitinol part of the hybrid aortic dissection stent (white arrowheads); the tip of the 9-F balloon-guided catheter (black arrowheads) was located in the proximal part of the left internal carotid artery.(image from Maleux 2023)
🔀Once in place, the clot is removed using specialized tools inside the catheter, such as:
🔀Suction: A device pulls or vacuums the clot out.
🔀Stent retriever: A special mesh or stent is deployed into the clot to grip it, and then the stent and clot are pulled out together.
🔀Sometimes, the clot is broken into smaller pieces first or a balloon is used to remove it.
🔀After the clot is removed, the catheter and guide wire are withdrawn.
🔀Sometimes if a stent is needed to keep the artery open, it is left in place.
🔀The small incision is closed with stitches or by applying firm pressure to stop any bleeding.
🔀The incision site is kept clean and bandaged as it heals.
🔀You will be moved to a recovery ward to be monitored as you wake up from the anaesthesia.
▶️What are the 5 most common serious complications after a thrombectomy?
1️⃣Bleeding
2️⃣Damage to the blood vessel
3️⃣Infection
4️⃣Reaction to anaesthetic
5️⃣Dislodging the clot.
▶️After you have been discharged, watch out for the following symptoms:
🟠Swelling or pain that gets worse
🟠Fluid leaking, redness, or swelling from the incision
🟠 Fever
🟠Bleeding anywhere
🟠Weakness, pain or numbness in the surgery area.
You are always advised to call your healthcare provider right away or get immediate medical care if you have any of the above symptoms.
▶️What is recovery like after a thrombectomy?
Patients we see normally stay at the hospital for a day or more, depending on their condition. Your medical team will be able to tell you when it is the right time for you to go home.
🟠Some patients I see are given blood thinners medication to take home for a short time to help prevent blood clots. Still your doctor will discuss this with you.
🟠You are normally advised to wear compression stockings. This is to help prevent the clot from forming again
🟠You are normally advised to get back on your feet soon after the treatment to help with circulation and prevent new clotting. You are advised to walk and rest repeatedly for up to 6 hours after the surgery to assist with vascular healing.
🟠You may drive yourself in 24 hours.
🟠Avoid exercise or exertion until the wound is completely healed (around 72 hours).
🟠Sometimes you are advised to avoid long-haul travel for 4 weeks either side of your surgery. Inform your surgeon of your travel plans. Travel socks may be advised for long journeys 1-2 months after surgery.
🟠If you are a smoker, you may be advised to stop smoking. This will help to lower your risks of blood clots forming in future.
🟠You are normally given a follow up appointment to check on your blood vessels with an imaging test called venogram or an angiogram to keep track of your progress.
▶️Thrombectomy recovery time?
Thrombectomy recovery time varies greatly, with some patients recovering quickly and others taking months or longer.
Short-term recovery (1–3 months)
Full recovery: Many patients feel mostly back to normal within 3 to 6 months.
Continued improvement: For others, especially after a large clot or delayed treatment, the recovery process can take up to a year or longer, with improvements sometimes continuing for several years.
We have come to the end of this article; hope I have given you some reassurance. Wishing you a quick recovery!🙋
📚Source:
Kaesmacher J, Cavalcante F, Kappelhof M, Treurniet KM, Rinkel L, Liu J, Yan B, Zi W, Kimura K, Eker OF, Zhang Y, Piechowiak EI, van Zwam W, Liu S, Strbian D, Uyttenboogaart M, Dobrocky T, Miao Z, Suzuki K, Zhang L, van Oostenbrugge R, Meinel TR, Guo C, Seiffge D, Yin C, Bütikofer L, Lingsma H, Nieboer D, Yang P, Mitchell P, Majoie C, Fischer U, Roos Y, Gralla J; IRIS Collaborators. Time to Treatment With Intravenous Thrombolysis Before Thrombectomy and Functional Outcomes in Acute Ischemic Stroke: A Meta-Analysis. JAMA. 2024 Mar 5;331(9):764-777. doi: 10.1001/jama.2024.0589. PMID: 38324409; PMCID: PMC10851137.
Alawieh A, Vargas J, Fargen KM, Langley EF, Starke RM, De Leacy R, Chatterjee R, Rai A, Dumont T, Kan P, McCarthy D, Nascimento FA, Singh J, Vilella L, Turk A, Spiotta AM. Impact of Procedure Time on Outcomes of Thrombectomy for Stroke. J Am Coll Cardiol. 2019 Mar 5;73(8):879-890. doi: 10.1016/j.jacc.2018.11.052. PMID: 30819354.
Maleux G, Rega, F, Lemmens R . Stroke Thrombectomy through Interstices of a Hybrid Endograft Placed for Type A Aortic Dissection.Journal of Vascular and Interventional Radiology, Volume 34, Issue 9, 1622 – 1624
Mathews S, De Jesus O. Thrombectomy. [Updated 2023 Aug 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562154/