Endovascular therapy (EVT)

Endovascular therapy (EVT), or mechanical thrombectomy, is a minimally invasive, highly effective treatment for acute ischemic stroke caused by large vessel occlusions (LVO). It involves navigating catheters through blood vessels to remove blood clots using specialized devices.

Window period for medical management for thrombolysis lasts upto 4.5 hours of stroke onset, while endovascular interventions for stroke can be perform upto 24 hours of symptoms onset, but ideally it should be done as early as possible. With over millions of neurons loosing per minue, time is crual. Endovascular treatment for stroke offers significantly improved functional outcomes, lower mortality, and faster recovery compared to medical management alone, even in cases with large ischemic cores.

Key Aspects of Endovascular Therapy for Stroke:

Procedure Details: Performed by neurointerventionalists, Dr Saurabh Kumar Sinha
A catheter is inserted—usually through the groin—and guided to the blocked brain artery using X-ray imaging.

Techniques: Mechanical Thrombectomy: Uses stent retrievers (stent-based) or aspiration catheters (suction-based) to remove the clot and restore normal blood flow towards brain tissue.

Intra-arterial Thrombolysis: Delivers clot-dissolving drugs directly to the blockage.

Angioplasty/Stenting: Used if the vessel is too narrow or for tandem occlusions stent is placed in brain to prevent restenosis.

Sometime, patient may require even more perfusion, then bypass surgery in brain can also be done to enhance blood flow and prevent stroke