Pulmonary thrombectomy: Difference between revisions
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*Rotational embolectomy | *Rotational embolectomy | ||
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. | |||
Mechanical thrombectomies can be | Mechanical thrombectomies can be | ||
Revision as of 01:57, 14 December 2011
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Pulmonary Embolism Microchapters |
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Diagnosis |
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Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
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Treatment |
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Follow-Up |
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Special Scenario |
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Trials |
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Case Studies |
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Pulmonary thrombectomy On the Web |
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Risk calculators and risk factors for Pulmonary thrombectomy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In thoracic surgery, a pulmonary thrombectomy, is an emergency procedure that removes clotted blood (thrombus) from the pulmonary arteries. Embolectomy can be done via a catheter or surgically.
Types
- Catheter embolectomy
- Rheolytic embolectomy
- Rotational embolectomy
- Surgical embolectomy
Description
- Rheolytic embolectomy
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.
Insertion of a large catheter increases the risk of bleeding which pose as the major disadvantage.
- Rotational embolectomy
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.
Mechanical thrombectomies can be
- Surgical (surgical thrombectomy)
- Percutaneous (percutaneous thrombectomy) [1].
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.[2]
Relation to PTE
Pulmonary thrombectomies and pulmonary thromboendarterectomies (PTEs) are both operations that remove thrombus. Aside from this similarity they differ in many ways.
- PTEs are done non-emergently whilst pulmonary thrombectomies are typically done as an emergency procedure.
- PTEs typically are done using hypothermia and full cardiac arrest.
- PTEs are done for chronic pulmonary embolism, thrombectomies for severe acute pulmonary embolism.
- 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.
See also
References
- ↑ Casazza F, Roncon L, Greco F. Pulmonary embolism: treatment of the acute episode. Ital Heart J. 2005 Oct;6(10):818-23. PMID 16270473.
- ↑ Augustinos P, Ouriel K. Invasive approaches to treatment of venous thromboembolism. Circulation. 2004 Aug 31;110(9 Suppl 1):I27-34. PMID 15339878. Free Full Text.