Pulmonary thrombectomy: Difference between revisions
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**Embolus trapped within patent foramen ovale, right atrium or the right ventricle, as evident on Echocardiography. | **Embolus trapped within patent foramen ovale, right atrium or the right ventricle, as evident on Echocardiography. | ||
*Benefits | *Benefits | ||
**Among patients failing initial thrombolysis, surgical embolectomy was found to have fewer death rates and fewer major bleedings. | **Among patients failing initial thrombolysis, surgical embolectomy was found to have fewer death rates and fewer major bleedings<ref name="pmid16608956">{{cite journal| author=Meneveau N, Séronde MF, Blonde MC, Legalery P, Didier-Petit K, Briand F et al.| title=Management of unsuccessful thrombolysis in acute massive pulmonary embolism. | journal=Chest | year= 2006 | volume= 129 | issue= 4 | pages= 1043-50 | pmid=16608956 | doi=10.1378/chest.129.4.1043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16608956 }} </ref>. | ||
==Relation to PTE== | ==Relation to PTE== | ||
Revision as of 02:26, 14 December 2011
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Pulmonary Embolism Microchapters |
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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.
Surgical embolectomy: This procedure is typically limited to large medical centers (as it requires experienced surgeon and cardiopulmonary bypass).
- Indications
- Hypotensive patients in which thrombolysis is contraindicated.
- Embolus trapped within patent foramen ovale, right atrium or the right ventricle, as evident on Echocardiography.
- Benefits
- Among patients failing initial thrombolysis, surgical embolectomy was found to have fewer death rates and fewer major bleedings[1].
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
- ↑ Meneveau N, Séronde MF, Blonde MC, Legalery P, Didier-Petit K, Briand F; et al. (2006). "Management of unsuccessful thrombolysis in acute massive pulmonary embolism". Chest. 129 (4): 1043–50. doi:10.1378/chest.129.4.1043. PMID 16608956.