Medically reviewed by Dheeraj Gandhi, MD, Seemant Chaturvedi, MD, Sridhara Yaddanapudi, MD, Shyam Majmundar, MD.
Imagine being able to stop a stroke by quickly taking out the blood clot in the brain that causes it. Specially trained doctors and a procedure called mechanical thrombectomy have made this possible.
According to the Centers for Disease Control and Prevention, stroke claims the lives of about 43 out of every 100,000 Marylanders. It is the state’s third-leading cause of death. At the University of Maryland Medical Center (UMMC) Comprehensive Stroke Center, interventional neurosurgeons treat a serious type of stroke using a minimally invasive procedure: mechanical thrombectomy.
A game-changer for stroke care, mechanical thrombectomy allows some patients to leave the hospital as if nothing had happened. Soon, even more Marylanders will have access to this procedure close to home.
What Is Mechanical Thrombectomy?
A specialized physician called a neurosurgeon performs mechanical thrombectomy, which is an endovascular procedure. This means the physician uses small, hollow tubes called catheters to work inside the blood vessels. The interventional neurologist guides the catheters from the groin to the brain and uses special tools to remove the clot causing the stroke. Taking out the clot restores blood flow and stops the stroke.
Who Is a Candidate?
Most strokes are ischemic (caused by a blocked blood vessel in the brain). Mechanical thrombectomy treats a serious type of ischemic stroke called a large vessel occlusion (LVO). An LVO is a blockage in a major brain artery.
“An ideal candidate for mechanical thrombectomy is someone with an LVO who arrives at UMMC within 24 hours after symptoms started,” said Dheeraj Gandhi, MD, professor of radiology, neurology and neurosurgery, and director of neurointerventional surgery. “The patient also needs to be healthy enough to have a surgical procedure.”
Steps to Treatment
If you experience stroke symptoms, call 911 right away. Here’s what will happen next:
- Emergency medical services (EMS) personnel will respond. They will examine you to determine whether you might have an LVO and be a candidate for mechanical thrombectomy. This in-field screening is part of a pilot program by Maryland EMS that ensures patients who may have an LVO are sent straight to a hospital, such as UMMC, that can perform thrombectomy.
- At the hospital, you’ll get a CT scan. This test helps physicians figure out what kind of stroke you’re having and whether you’re a good fit for mechanical thrombectomy.
- If you arrive at the hospital within four and a half hours after your symptoms started, you’ll get clot-busting medicine in the emergency department. This medicine is given through a needle in your vein and can dissolve the clot. However, many patients with an LVO still need a thrombectomy even after getting this medicine.
- Finally, you’ll go to the angiography suite, where an interventional neurosurgeon will perform the procedure.
How Mechanical Thrombectomy Is Done
You can have a mechanical thrombectomy up to 24 hours after a stroke starts. This procedure doesn’t use large incisions like open surgery. Instead, the physician makes a small incision in your groin or wrist to insert the catheters. They send the catheters through your blood vessels until they reach the blockage in your brain. Once there, they use one of two methods to remove the clot.
“The physician may use aspiration, which is like vacuuming out the clot,” said Seemant Chaturvedi, MD, the Stewart J. Greenebaum Endowed Professor in Stroke Neurology at the University of Maryland School of Medicine and director of the stroke division and program at the University of Maryland Medical System (UMMS). “On the other hand, they may put a small device called a stent retriever into the catheter to remove the clot. The device entangles the clot so the physician can pull it out.”
The procedure is over in minutes. You will get a special X-ray test called an angiogram to check that blood flow has returned to the brain. If the images look good, you will go to the Intensive Care Unit (ICU).
What Happens After Mechanical Thrombectomy
The ICU team will watch you closely for problems, like bleeding in the brain, for at least 24 hours. Many patients can go home after one or two days. Some may need to go to an inpatient rehabilitation facility to build their strength and functional abilities.
“Some patients who have mechanical thrombectomy can walk out of the hospital without assistance and return home,” said Sridhara Yaddanapudi, MD, neurologist at UM Capital Region Medical Center and director of stroke operations for UMMS. “They can get back to their regular lives in a matter of days. That, to me, is one of the miracles of medicine.”
Stroke Treatment’s New Frontier
In 2025, UMMC performed more than 250 mechanical thrombectomies, surpassing 200 for the first time. The hospital in downtown Baltimore routinely performs better than national benchmarks for complications and restoring blood flow. Now, this high-level care is also available outside the city.
Interventional neurologists recently began performing mechanical thrombectomy on a part-time basis at UM Capital Region Medical Center. Soon, the procedure will be available there 24/7.
“For patients in Prince George’s County, having mechanical thrombectomy available around the clock in their community will be transformative,” said Shyam Majmundar, MD, assistant professor of neurology and neurological surgery at the University of Maryland School of Medicine and medical director of neurointerventional surgery at UM Capital Region Medical Center. “Patients can receive advanced stroke treatment closer to home, resulting in faster treatment times and more patients returning to independent lives.”
Saving Lives and Quality of Life
For Marylanders, the future of stroke care is happening now. Mechanical thrombectomy can prevent death and disability from one of the most serious types of stroke.
Available 24/7 at UMMC, mechanical thrombectomy is appropriate for people who have an LVO and arrive at the hospital within 24 hours after symptoms start. The procedure requires only a small incision and uses specialized tools to remove blood clots from the brain in minutes. With UM Capital Region Medical Center also set to offer mechanical thrombectomy around the clock soon, this procedure is poised to help even more patients survive strokes.