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| __NOTOC__
| | #Redirect [[Pulmonary embolism embolectomy]] |
| {{Pulmonary embolism}}
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| {{CMG}}
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| ==Overview==
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| In [[thoracic surgery]], a '''pulmonary thrombectomy''', is an [[emergency procedure]] that removes [[blood clot|clotted]] [[blood]] ([[thrombus]]) from the [[pulmonary artery|pulmonary arteries]]. Embolectomy can be done via a catheter or surgically.
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| ==Types==
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| *Catheter embolectomy
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| **Rheolytic embolectomy
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| **Rotational embolectomy
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| *Surgical embolectomy
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| ==Description==
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| *Rheolytic embolectomy
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| Pressurized saline is passed through a catheter's distal tip, which breaks-down the emboli. The saline and clot fragments are then sucked back into an exhaust lumen of the catheter and disposed off.
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| Insertion of a large catheter increases the risk of bleeding which pose as the major disadvantage.
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| *Rotational embolectomy
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| As the name suggest, a rotational device is used to fragment the thrombus. In this, cardiac catheters are used, which does not require venotomy at the puncture site. The fragments are continuously aspirated.
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| Mechanical thrombectomies can be
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| *Surgical (surgical thrombectomy)
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| *Percutaneous (percutaneous thrombectomy) <ref>Casazza F, Roncon L, Greco F. Pulmonary embolism: treatment of the acute episode. Ital Heart J. 2005 Oct;6(10):818-23. PMID 16270473.</ref>.
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| Surgical thrombectomies were once popular but were abandoned because of poor long-term outcomes. Recently, in selected patients, they have gone through a resurgence with the revision of the surgical technique.<ref>Augustinos P, Ouriel K. Invasive approaches to treatment of venous thromboembolism. Circulation. 2004 Aug 31;110(9 Suppl 1):I27-34. PMID 15339878. [http://circ.ahajournals.org/cgi/content/full/110/9_suppl_1/I-27 Free Full Text].</ref>
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| ==Relation to PTE==
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| Pulmonary thrombectomies and [[pulmonary thromboendarterectomy|pulmonary thromboendarterectomies]] (PTEs) are both operations that remove thrombus. Aside from this similarity they differ in many ways.
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| *PTEs are done non-emergently whilst pulmonary thrombectomies are typically done as an emergency procedure.
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| *PTEs typically are done using hypothermia and full cardiac arrest.
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| *PTEs are done for chronic pulmonary embolism, thrombectomies for severe acute pulmonary embolism.
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| *PTEs are generally considered a very effective treatment, surgical thrombectomies are an area of some controversy and their effectiveness a matter of some debate in the medical community.
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| ==See also==
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| *[[Pulmonary embolism surgery|Pulmonary embolism Surgical Therapy]]
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| *[[Pulmonary embolism]]
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| *[[Heart-lung machine]]
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| *[[Pulmonary embolism ACC/AHA guidelines surgical embolectomy|ACC/AHA Guidelines Surgical Embolectomy]]
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| ==References==
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| {{Reflist|2}}
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| [[Category:Thoracic surgery]]
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| [[Category:Surgical procedures]]
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