2. INTRODUCTION:
• Embolectomy is emergency surgical removal
of emboli which are blocking blood circulation.
• It usually involves removal of thrombi (blood
clots), and is then referred to as thrombectomy.
• Embolectomy is an emergency procedure often
as the last resort because permanent occlusion
of a significant blood flow to an organ leads
to necrosis.
• Other involved therapeutic options are
anticoagulation and thrombolysis.
3. • Emboli are abnormal masses of material (which can be
solid, liquid or gas) that are carried in the blood stream
from one part of the circulation to another causing a
blockage (occlusion) of a blood vessel that leads to lack
of oxygen supply (ischemia) and
finally infarction of tissue downstream of the embolus.
• The most common type of emboli are a blood clot
generated by thrombosis which has then broken off and
is then transported in the blood stream
• There are two areas where emboli can form and
therefore impact:
1. Arterial emboli form in the left side of the heart or the
main arteries, they impact in body tissues but not the
lungs, commonly in the brain and the small vessels in
the upper and lower limbs
2. Venous emboli arise in veins (for example emboli which
form from deep venous thrombosis or DVT) and these
impact in the lung
4. INDICATIONS:
• Massive pulmonary embolism (PE)
• Used for patients with persisting shock
despite supportive care and who have an
absolute contraindication for thrombolytic
therapy.
• Arterial embolisms in acute limb ischemia
• Mesenteric ischemia
• Stroke
5. METHODS:
• Catheter embolectomy
• Balloon embolectomy
Typically this is done by inserting a catheter with an inflatable balloon
attached to its tip into an artery, passing the catheter tip beyond the clot,
inflating the balloon, and removing the clot by withdrawing the catheter.
• Aspiration embolectomy
Catheter embolectomy is also used for aspiration embolectomy, where the
thrombus is removed by suction rather than pushing with a balloon. It is a
rapid and effective way of removing thrombi in thromboembolic occlusions
of the limb arteries below the inguinal ligament, as in leg infarction.
• Surgical embolectomy
Surgical embolectomy is the simple surgical removal of a clot following
incision into a vessel by open surgery on the artery.
7. OUTCOME:
• Outcome of embolectomy varies with size
and location of the embolus.
• In pulmonary embolism recent data shows
mortality as being approximately 20%.
• Although this is a high mortality, it may
have life-saving potential in some
instances.