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Medical Technology

Doctors perform Endovascular Thrombectomy to save an elderly woman

Endovascular-Thrombectomy

~The senior suffered an Acute stroke at the time of Chemotherapy; Doctors at the hospital performed emergency life-saving surgery~

A 72yr old woman while undergoing Oral Chemotherapy for Lung Cancer, suddenly developed severe weakness on the right side of her body and face which also affected her speech. She was doing reasonably well before the incident. She was brought to the Emergency Department of Hiranandani Hospital, Vashi- A Fortis Network Hospital where she was attended to by the Stroke Team headed by Dr Pawan Ojha, Consultant Neurologist and Stroke Specialist.

Endovascular-Thrombectomy

The patient was rushed for an MRI of the Brain which revealed complete blockage of the main blood vessel i.e. the Left Internal Carotid Artery causing significant brain infarcts(strokes) and damage due to lack of blood supply. In such a situation, the patient is usually treated within 4.5 hours of stroke onset using a clot buster medicine names Actilyse, administered by an intravenous route. Doctors were not able to administer this medicine as she had tendency to bleeding which was caused due to a very low platelet count. It was decided to remove the clot using a technique named ‘Endovascular Thrombectomy’. The procedure is routinely performed in the Cath Lab of this hospital for patients with acute stroke caused due to blocked Brain arteries. This procedure needs to be performed within a 6-8hrs of the onset of stroke, earlier the procedure, better the chances of a good outcome.

The procedure was done by a team of Neuro-Intervention Specialists and multiple bits of clots were removed immediately, restoring blood supply to the affected brain areas. The patient responded well to procedure and after a few hours was able to move her right limbs, however continued having some difficulty in speaking and swallowing food due to residual brain damage. After conducting a repeat MRI Brain angiogram, the scans showed complete resolution and small residual area of brain damage. If the procedure hadn’t been conducted, there was a high possibility of damage to the entire left side of the brain resulting into severe swelling and higher risk of death due to complications.

A similar clot was found in the right leg artery which caused the patient intolerable pain and blackish discoloration of the right foot. With the help of Dr Brajesh Kumar Kunwar, Interventional Cardiologist at the hospital, the clot was extracted in the Cath Lab, using a similar procedure. The patient had a difficult time coping with severe bodily weakness as her platelets were extremely low and she had difficulty in breathing due to underlying Pneumonia. She underwent physiotherapy and was initially fed using a nasogastric tube. A magnetic stimulation device was used which took care of residual spasticity and fastened recovery.

Speaking about the procedure Dr Pawan Ojha Consultant Neurologist & Stroke Specialist, said “The patient has responded well to the procedure and the overall treatment, her health is now improving. Her feeding tube has been removed. She is able to use her limbs fully, is able to talk, walk and eat by herself and is currently visiting the hospital for follow-ups. There are practically no residual symptoms of stroke”.

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